Justice Department Joins Whistleblower Lawsuit against IPC the Hospitalist Co. By Tod Aronovitz | 12/13/13 | 0 Comment

The government has intervened in a whistleblower lawsuit alleging the overbilling of physician services by IPC The Hospitalist Co. Inc, and its subsidiaries (IPC), the U.S. Department of Justice announced.  IPC, which has a Southeast Florida office in Coral Gables, is one of the largest providers of hospitalist services in the United States.  The company employs hospitalists—or physicians, who work only in hospitals and longer-term care facilities, directing inpatient care from admission to discharge—in more than 1,300 facilities across 28 states.

According to the lawsuit, physicians allegedly engaged in “upcoding,” a practice in which doctors seek payment for more expensive levels of health care than actually provided. Further, the lawsuit claims that IPC allegedly pushed for its physicians to bill at the high levels regardless of service, trained them to use the high level codes, and encouraged those with lower billing levels to attain the higher billing levels of their peers.

Former IPC physician, Dr. Bijan Oughatiyan, filed the lawsuit under the qui tam provisions of the False Claims Act.  The False Claims Act also enables the government to intervene or take over a lawsuit if evidence shows that an argument can be made for fraud under the Act, and to recover three times its damages plus civil penalties. After making that determination in this case, the government has asked the U.S. District Court in Chicago for 120 days to file its own complaint stating its allegations.

One of the most powerful tools in the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative is the False Claims Act. Since January 2009, the Justice Department has recovered more than $17 billion through False Claims Act cases, with more than $12.2 billion of that amount recovered in cases involving fraud against federal health care programs.

“We continue to be vigilant in our enforcement efforts to ensure that health care programs funded by the taxpayers pay only for appropriate costs,” Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery said in a news release issued by the Department.

How to Report Miami Medicare Fraud

Healthcare or medical billing employees who have inside knowledge of questionable Medicare billing practices can file a confidential legal claim under the False Claims Act. By acting as a “whistleblower” in what is known as a “qui tam” lawsuit, a private party may collect between 10 to 30 percent of the amount recovered, depending on how the case is prosecuted.

ARONOVITZ LAW: Miami Whistleblower / Qui Tam Law Firm

The Miami qui tam law firm of ARONOVITZ LAW routinely works with Miami whistleblowers to document Medicare fraud and other forms of fraud against the government. Contact Miami Whistleblower / qui tam lawyer Tod Aronovitz to discuss a case.