Ross Feller Casey today announced that the owners of a pain clinic with offices in Pennsylvania and New Jersey have agreed to pay $1.78 million to settle a whistleblower lawsuit alleging they billed Medicare for procedures that were not medically necessary or were not actually performed.
The agreement with the Atlantic Spine & Joint Institute and its owners, Robert C. McGrath, Sr., D.O., and Robert C. McGrath, Jr., settles a civil lawsuit filed under the U.S. False Claims Act by a former billing manager at the practice. The practice serves approximately 3,000 patients at offices in Haddon Township, N.J., and Wayne, Pa.
Among other things, the lawsuit alleged that the McGraths, father and son, routinely submitted false claims to the government for procedures that were not medically necessary and billed for x-rays on most if not all patients in order to increase profits. The clinics also routinely billed the government and received payments for full physical therapy sessions even though the sessions often were much shorter than reported or were performed by non-licensed therapists.
Robert C. McGrath, Sr., is a doctor of osteopathic medicine and the practice’s director of medical services. Robert C. McGrath, Jr., is a chiropractor and the clinic director. The practice focuses on knee and back pain by non-surgical methods, including injections and physical therapy.
“The McGraths were rewarded financially and patients were placed at risk when unlicensed and untrained employees performed procedures a licensed physician must oversee or perform himself. The defendants enriched themselves at the expense of those patients, many of whom were elderly, and the government,” said attorney Brian J. McCormick, Jr., of Ross Feller Casey, a nationally-recognized whistleblower attorney who represented the whistleblower in the case. “In addition to yielding a recovery for taxpayers, this settlement should deter similar conduct in the future. This case should stand as a warning to those who choose to put profits above patient care.”
The whistleblower worked as the billing manager for the medical practice from 2013 to 2015, until she was terminated for reporting the fraud to the federal government. Under the agreement, she will receive more than $380,000 of the settlement proceeds. The federal False Claims Act contains a provision that permits whistleblowers to file suit on behalf of the U.S., and to share in any recovery.
McCormick also praised the government attorneys and investigators who worked on the case. “Their tireless efforts gave the McGraths little choice but to settle,” McCormick said. “The U.S. Attorney’s Office in New Jersey did a fantastic job, and those attorneys and the investigators from the FBI and HHS should be commended.” Dena Young of Ross Feller Casey assisted McCormick on the case.
If you have information about fraud involving federal funds or against the U.S., or a state or local, government, past or present, you should contact Ross Feller Casey’s whistleblower lawyers now for a free, confidential case evaluation.