Medicare fraud

A settlement has been reached in a whistleblower class action lawsuit brought against a Tennessee cardiologist, Dr. Elie H. Korban, who is accused of billing Medicare and Medicaid for medically unnecessary cardiac stent placements.

The whistleblower's share of the recovery has not been determined. 

The initial lawsuit was filed in June 2007.  The governments allegations against Korban included that, from January 1, 2005, through December 31, 2008, Korban placed cardiac stents in Medicare and Medicaid patients when the stents were not medically necessary .  The government also claims that Korban improperly billed Medicare for work performed by substitute doctors when he was available to perform the services himself.

A settlement has been reached in a whistleblower class action lawsuit brought against Saint Joseph Health System Inc who is accused of submitting false claims to the Medicare and Kentucky Medicaid programs for a variety of medically unnecessary cardiac procedures.

The originally filing whistleblowers will receive a $2.46 million share of the government's recovery.

The initial whistleblower case was filed in March of 2011. The government's lawsuit alleges that doctors working at Saint Joseph Hospital performed numerous invasive cardiac procedures, including coronary stents, pacemakers, coronary artery bypass graft surgeries and diagnostic catheterizations, on Medicare and Medicaid patients who did not need them, and that the hospital was aware of these unnecessary procedures.  These doctors were affiliated with Cumberland Clinic which is a physician group that entered an exclusive arrangement with Saint Joseph Hospital in 2008 to provide cardiology services to the hospital’s patients.  Cumberland Clinic is owned by two London-based cardiologists, Satyabrata Chatterjee and Ashwini Anand. The government complaint makes further allegations that Saint Joseph Hospital violated the federal Stark Law and Anti-Kickback Statute by entering into sham management agreements that financially benefitted Chatterjee and Anand as an inducement for Chatterjee and Anand to direct more Cumberland Clinic patients to the hospital. 

A settlement has been reached to resolve False Claims Act allegations against SelfRefind, PremierTox LLC,  and the owners of SelfRefind and PremierTox.  They are accused of submitting claims to Medicare and Kentucky’s Medicaid program for tests that were medically unnecessary, more expensive than those performed or billed in violation of the Stark Law.

The government alleged that, after Wood and Peavler became owners of PremierTox, SelfRefind began referring comprehensive urine drug screening tests to PremierTox that were unnecessary and many times more expensive than other suitable alternative tests.  The government also alleged that PremierTox submitted to Medicare and Medicaid inflated claims that misidentified the class of drug being tested and billed for tests that were referred by SelfRefind in violation of the Stark law.