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Wednesday, May 20, 2015

Government Settles False Claims Act Allegations against Florida Neurologist for $150,000

Dr. Sean Orr of Jacksonville, Florida, has agreed to pay $150,000 to settle allegations that he violated the False Claims Act by providing medically unnecessary services and drugs to federal health care program beneficiaries, the Department of Justice announced today.  Dr. Orr is a neurologist formerly employed by Baptist Neurology Inc. and Baptist Medical Center-Jacksonville. 

“The public relies on doctors to treat their patients with integrity and not waste taxpayer dollars,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Justice Department’s Civil Division.  “The Justice Department will continue to hold accountable physicians who make false diagnoses or otherwise provide medically unnecessary treatment.”   

This settlement resolves allegations that, from September 2009 to April 2012, Orr knowingly misdiagnosed certain patients with various neurological disorders, such as multiple sclerosis (MS), which caused federal health care programs to be billed for medically unnecessary services and drugs.  The alleged misconduct affected beneficiaries in the Medicare, TRICARE and the Federal Employees Health Benefits programs.  The settlement is based on Orr’s ability to pay.   

“Our office will relentlessly pursue physicians who misdiagnose and harm patients to satisfy their financial greed,” said U.S. Attorney A. Lee Bentley III of the Middle District of Florida.  “We expect physicians to act honestly, with integrity, and in accordance with the approved standards of medical care.  When they do not, we all suffer.”

“Physicians who knowingly misdiagnose serious illnesses and provide unnecessary services in order to bill federal healthcare programs violate the trust their patients and the taxpayers have in the medical profession,” said Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG).  “Our agency will continue to thoroughly investigate health care professionals involved in such duplicity and waste.”   

In 2014, the government settled related allegations against Baptist Health System Inc. – Orr’s former employer and the parent company for Baptist Neurology Inc. and Baptist Medical Center-Jacksonville – for $2.5 million. 

“Dr. Orr violated the trust placed in him by his patients,” said Inspector General Patrick E. McFarland of the U.S. Office of Personnel Management (OPM).  “Federal employees deserve health care providers who meet the highest standards of ethical and professional behavior.  Today’s settlement reminds all providers that they must observe those standards, and reflects the commitment of federal law enforcement organizations to pursue improper and illegal conduct that puts the health and wellbeing of their patients at risk.” 

The government’s investigation was initiated by a qui tam, or whistleblower, lawsuit filed under the False Claims Act by Verchetta Wells, a former Baptist Neurology Inc. employee.  The act allows private citizens to file suit for false claims on behalf of the government and to share in the government’s recovery.  Wells will receive $26,250 from the settlement with Orr. 

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  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 $24 billion through False Claims Act cases, with more than $15.3 billion of that amount recovered in cases involving fraud against federal health care programs.

This settlement is the result of a coordinated effort among the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office of the Middle District of Florida, HHS-OIG, the Defense Health Agency’s Program Integrity Office, and OPM’s Office of Inspector General.

The claims resolved by this settlement are allegations only, and there has been no determination of liability.  The lawsuit against Orr was filed in the U.S. District Court for the Middle District of Florida and is captioned United States ex rel. Wells v. Sean Orr, M.D. et al.

Updated May 20, 2015