United States Settles False Claims Act Lawsuit Against Florida Pain Clinic And Its Owner
Tampa, Florida – United States Attorney A. Lee Bentley, III announced today that a Florida-based physician, Dr. Steven Chun, has agreed to pay $750,000 to resolve allegations that he and his clinic billed Medicare for physician office visits that he did not perform.
The United States alleges that, between 2006 and 2011, Dr. Chun owned and operated a clinic, first in Sarasota and then in Bradenton, called Sarasota Pain Associates. The United States alleges that, beginning in 2006, Dr. Chun billed Medicare for office visits at the highest levels possible, falsely claiming to have conducted comprehensive examinations of patients with complex problems. In fact, those patients visited Sarasota Pain Associates for scheduled procedures for which Dr. Chun was paid. In addition to getting paid for those procedures, Dr. Chun billed and was paid by Medicare for examinations that he did not in fact perform.
"This settlement is a significant achievement by our Civil Division, which showed great determination in pursuing a troubling pattern of billing fraud," said U.S. Attorney A. Lee Bentley, III. "This case should send a message that we will not tolerate this kind of health care fraud in the Middle District of Florida."
"Count on my agency to aggressively pursue cases whether the target is a large corporation or a single provider," said Christopher B. Dennis, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General Miami region. "Besides a significant payment, Dr. Chun has agreed to let an independent organization review his claims for three years and then report to the government."
The allegations covered by the settlement were raised in a lawsuit filed by Cathia Gavin and Penelope Thomas, who both formerly worked as nurses for Dr. Chun. The suit was filed under the qui tam or whistleblower provisions of the False Claims Act, which permit private parties to sue on behalf of the United States for the submission of false claims and to receive a share of any recovery. The False Claims Act authorizes the United States to intervene in such lawsuits and take over primary responsibility for settling or litigating them.
In addition to the $750,000 payment, Dr. Chun will enter into a three-year Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General. The agreement requires Dr. Chun to attend training courses provided by the Centers for Medicare and Medicaid Services and to conduct an independent external review of his coding, billing, and claims submission to federal health care programs.
This settlement illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of 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.
The investigation of this matter reflects a coordinated effort among the Commercial Litigation Branch of the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Middle District of Florida, and the U.S. Department of Health and Human Services’ Office of Inspector General.
The lawsuit is captioned U.S. ex rel. Gavin v. Sarasota Pain Associates, P.A. and Steven Y. Chun, M.D., 6:11-cv-583-T-23TBM (M.D. Fla.). The claims asserted against the defendants are allegations only, and there has been no determination of liability.