by Ben Vernia | June 15th, 2011
On June 14, the Department of Justice announced that it had filed a complaint in a qui tam, or whistleblower lawsuit in which it had intervened in May. The defendant in the case is a Tampa-based company, Bay Area Sleep Associates. According to DOJ’s press release:
The United States has filed a complaint under the False Claims Act (FCA) against Bay Area Sleep Associates LLC, dba SomnoMedics LLC, and its owner, Edward Killmer Jr., the Justice Department announced today. The complaint, filed today in U.S. District Court for the Middle District of Florida, alleges that the defendants violated the FCA by knowingly submitting, or causing to be submitted, to the United States false claims for payments from multiple federal health care programs.
The government’s complaint alleges that beginning no later than 2004, the defendants hired unlicensed sleep technicians to perform sleep tests at one or more of their facilities. Medicare regulations require that diagnostic testing services performed at independent diagnostic testing facilities such as SomnoMedics must be performed by a technician licensed or certified by a state or national credentialing body in order to be reimbursed by Medicare. The complaint alleges that SomnoMedics utilized unlicensed sleep technicians to perform sleep tests on Medicare and TRICARE beneficiaries, but knowingly requested payment for these services despite being fully aware that SomnoMedics failed to comply with federal program reimbursement regulations.
On May 27, DOJ announced a settlement in an apparently similar case in Arizona.