Three companies providing remote cardiac monitoring services, and one of their owners, agreed to pay more than $13.4 million to the government to settle a False Claims Act case brought by our client. The cardiac monitoring fraud settlement is a direct result of our client’s False Claims Act complaint against Medi-Lynx Cardiac Monitoring, LLC, AMI Monitoring, Inc., and Spectocor, LLC. The complaint alleged that defendants concocted a scheme to cause unwitting physicians to order the most lucrative services regardless of medical necessity or reasonableness.
Defendants utilized an online enrollment portal to steer physicians to select the highest reimbursing monitoring service. This happened, even when physicians intended to select less expensive monitoring services. Through this scheme, defendants caused Medicare to pay false claims to Medicare for unnecessary and unreasonable telemetry services. Under the terms of the settlement, defendants have agreed to pay over $13.4 million to resolve these claims.
Our client, Eben Steele, an employee of AMI/Spectocor, worked in the industry for many years. Mr. Steele believes that health care companies should serve their patients’ needs, not line their own pockets. He explained:
I was offended by this underhanded scheme. Not only was it overriding the doctor’s judgment about what the patient needed, but it was lining the Defendants’ pockets at the expense of the taxpayer. I am very grateful to Bob Thomas and Suzanne Durrell for helping me right this wrong and guide me through the process.
Mr. Steele approached us in late 2013 to see if, together, we could do something to stop this fraud. We investigated his allegations, compiled his evidence, and researched the law. Then, in March 2014, we filed and served his Complaint along with a statement detailing his evidence on the government. We then worked with the government over the course of the next three plus years until the settlement.
The cardiac monitoring fraud settlement resulted from a successful partnership between the government and our client. One of the most important factors in ensuring success for a whistleblower case is filing it in a district where the government prosecutors have the expertise and enthusiasm to ensure success. We filed Mr. Steele’s complaint in the district of New Jersey, permitting us to work with the excellent office there.
Whistleblowers like Mr. Steele are vitally important in the fight against government fraud. Under the FCA, a private citizen-relator who suspects or knows of fraud against the government can act as a whistleblower and file a sealed complaint on behalf of the government. If the case is successful, as it was here, the relator is entitled to a share of the government’s recovery.
In this case, after several years of hard work by Mr. Steele, his attorneys, and government prosecutors, our client will receive some $2.43 million for his part in stopping an ongoing fraud against the government and helping to ensure that government victims were compensated.
We offer Mr. Steele our congratulations and deep gratitude for his efforts on behalf of the government.