U.S. Attorney's Office Obtains Judgment Against Canyon Co. Psychiatrist for Medicare and Medicaid Fraud
BOISE – U.S. Attorney Wendy J. Olson announced today that her office's Affirmative Civil Enforcement Unit has prevailed in a lawsuit brought under the False Claims Act and obtained summary judgment in the amount of $93,556.26 against Canyon County psychiatrist Dr. Michael Applebaum. The government's civil lawsuit was brought under the False Claims Act.
According to court documents, from 2004 through part of 2009, Dr. Applebaum submitted false claims to Medicare and Medicaid for undocumented and ineligible services. The Idaho State Board of Medicine revoked Dr. Applebaum's license to practice medicine in May 2011. On August 10, 2011, a Canyon County jury convicted Dr. Applebaum of obstruction of investigation and provider fraud regarding false claims for other services. He has been in the custody of the Idaho Department of Corrections since November 21, 2011.
The False Claims Act prohibits knowingly presenting, or causing to be presented, to the federal government a false or fraudulent claim for payment or approval. Additionally, it prohibits knowingly making or using, or causing to be made or used, a false or fraudulent record or statement to get a false or fraudulent claim paid or approved by the federal government. Under 31 U.S.C. § 3729(a)(1), an individual who violates the False Claims Act is liable for a civil penalty of up to $11,000 for each violation, plus three times the loss sustained by the United States.
In Idaho, the federal government funds approximately 70% of all Medicaid money. Making a false claim to Medicaid is no different than making a false claim to the federal government for federal money.
The civil case was based on an investigation by the Idaho Attorney General's Office and the U.S. Department of Health and Human Services, Office of Inspector General.
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