Partner Elaine Stromgren
Florida-based American Sleep Medicine LLC has agreed to pay $15.3 million to settle allegations that it inappropriately billed government health care programs– including Medicare, the Railroad Retirement Medicare Program, and the military health care program TRICARE– for sleep diagnostic services. The United States Department of Justice announced the settlement today.
The James Hoyer Law Firm represents whistleblower Daniel Purnell who brought the charges to the attention of the government and filed suit under the False Claims Act to retrieve federal funds which he believed American Sleep collected in violation of the law. Purnell is a former employee who worked as a sleep technician at the American Sleep Medicine Clinic in California’s Silicon Valley.
James Hoyer Partner Elaine Stromgren called the settlement an important deterrent in the battle against health care fraud. “When businesses falsely bill the government for services, it costs taxpayers billions of dollars every year. Cases like this send a strong message to those who try to defraud the government that this will not be tolerated,” she said.
American Sleep is headquartered in Jacksonville, Florida. It is one of the nation’s largest sleep disorder treatment organizations in the country and owns and operates 19 facilities throughout the United States, in Alabama, California, Delaware, Florida, Illinois, Indiana, Kansas, Kentucky, Maryland, Missouri, New Jersey, Tennessee, Texas and Virginia. The company primarily provides testing for patients who suffer from sleep disorders, like sleep apnea.
Purnell’s whistleblower suit contended that American Sleep submitted false claims from 2004 through 2011 for payment to Medicare and TRICARE, because services were performed by technicians the company knew lacked the required credentials and certifications. Under federal program requirements, tests must be conducted by technicians who are licensed or certified by a state or national credentialing body as sleep test technicians.
U.S. Attorney David Hale for the Western District of Kentucky said pursuing health care fraud is a priority for the DOJ. “Medical providers who overbill Medicare defraud the taxpayers and drive up the cost of health care for us all. Recovering taxpayer dollars lost to fraud helps keep strong those critical public health care programs so many people depend on,” Hale said.
As part of the settlement, American Sleep also entered into a five-year Corporate Integrity Agreement, which will require enhanced accountability and monitoring by internal and external, independent reviewers.
Under the False Claims Act, Purnell is entitled to share in the government’s $15.3 million recovery. The whistleblower’s award in this case is $2.6 million.
The James Hoyer Law Firm has been successfully representing whistleblowers under the False Claims Act for nearly 20 years. The DOJ calls the False Claims Act one of the most powerful tools in its efforts to reduce and prevent Medicare and Medicaid financial fraud.