Sheller, P.C. announced today that Sarasota Pain Associates, P.A. (SPA) and its owner, Dr. Steven Chun, have agreed to pay $750,000 to resolve allegations by the law firm’s whistleblower clients that SPA violated the False Claims Act by submitting false claims to Medicare for procedures and services that he did not perform. During the time in question, SPA operated its pain management practice in Sarasota, Florida, and then in Bradenton.
The settlement today was the result of the extraordinary efforts of two whistleblowers: Cathia Gavin and Penelope Thomas. As nurses working for Dr. Chun, they uncovered the healthcare fraud involving patient services that were not being rendered, as well as services being billed at a higher level of service than was actually rendered.
The relators were represented by nationally-recognized whistleblower attorneys, Stephen A. Sheller and Brian J. McCormick, Jr. of Sheller, P.C. in Philadelphia, as well as Joseph A. Trautwein, Blue Bell, Pennsylvania, and Mary Ann Floyd, Diez and Floyd, P.A., Englewood, Florida. Relators Thomas and Gavin filed a whistleblower lawsuit under seal in the United States District Court for the Middle District of Florida in 2011. The lawsuit alleges that Dr. Chun and Sarasota Pain Associates orchestrated a scheme to submit false claims for payment for the unnecessary and unrendered procedures, which were paid by Medicare and Medicaid in violation of the False Claims Act. The United States joined their lawsuit on January 17, 2014.
“Penny Thomas and Cathia Gavin performed a great service to Florida residents,” said Brian J. McCormick, Jr., counsel for the whistleblowers. “The conduct in this case was a serious threat to public health and patient safety. The courageous actions of these whistleblowers helped bring to an end deplorable conduct that hurt patients and their families for no reason other than greed.”
“Doctors that place their financial interests above the well-being of their patients will be held accountable,” said Stephen A. Sheller, the founding partner of Sheller, P.C. “We cannot, and should not, tolerate those who abuse federal health care programs and put the beneficiaries of these programs at risk.”
The government alleged, according to court documents, that Dr. Chun knowingly submitted Medicare claims for patient evaluation and management services that were not rendered, patient evaluation and management services billed at a higher level of service than actually rendered, refills of implantable infusion pumps as if performed by a physician, when they were performed by a nurse, and injections that were not rendered.
In connection with this settlement, Dr. Chun and SPA have agreed to enter into an Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General, which obligates Dr. Chun to attend training courses provided by the Center for Medicare Services and to conduct an independent external review of his coding and billing processes.
Brian McCormick added, “It takes great courage for someone to come forward in a situation like this. While our clients were very much afraid of the impact it might have on their jobs, they were more concerned about helping others. I am incredibly proud of them, and honored to have played a part.”
The settlement announced yesterday stems from a whistleblower complaint filed by the two former nurses pursuant to the qui tam provisions of the False Claims Act, which permit private persons to bring a lawsuit on behalf of the government and to share in the proceeds of the suit. The Act also permitted the government to intervene in the lawsuit and take over the allegations.
Federal and state False Claims Acts allow private citizens with insider knowledge of fraud, waste, and abuse to bring an action on behalf of the governments and to participate in the recovery of the stolen funds. These statutes allow governments to recover three times the amount they were defrauded, in addition to civil penalties of $5,500 to $11,000 per false claim. Successful whistleblowers can receive between 15 and 30 percent of the governments’ recovery.
The settlement was achieved through the coordinated efforts of a team of attorneys from the U.S. Department of Justice and the U.S. Attorney’s Office for the Middle District of Florida. The team was led by Randy Harwell, Chief of the Civil Division in the U.S. Attorney’s Office from Middle District of Florida and Assistant U.S. Attorney Kathy Ho of the Middle District of Florida.
The U.S. Attorney’s Office in Tampa did a fantastic job,” said McCormick. “Civil Chief Randy Harwell, Assistant U.S. Attorney Kathy Ho and Special Agent Ian Ives of the Office of Inspector General for HHS should be commended for their tireless work on this case.”
The lawsuit is captioned United States ex rel. Gavin and Thomas v. Steven Chun, M.D. and Sarasota Pain Associates, P.A., No. 8:11-cv-583-T-23TBM (M.D. Fla.).
United States Settles False Claims Act Lawsuit Against Florida Pain Clinic And Its Owner, U.S. Department of Justice Press Release, February 25, 2014
Sarasota Doctor Pays $750,000 to Settle Lawsuit, The Sarasota Herald-Tribune, February 25, 2014
Pain Clinic Physician Settles Medicare Billing Lawsuit, Tampa Bay Business Journal, February 25, 2014