Brandon Pulmonary Practice Agrees to Pay Over $400,000 to Resolve False Claims Act Violations

Tampa, FL – Pulmonary Associates of Brandon, P.A. has agreed to pay $419,410 to resolve allegations that it violated the False Claims Act by submitting claims to Medicare for certain Evaluation and Management (“E&M”) codes. The government contends that the underlying services were medically unnecessary and the claims in issue should have been properly submitted under a lower E&M code from January 2017 through March 2020. 

“The submission of false and medically unnecessary claims to Medicare for office visits compromises the integrity of our nation’s federal health care programs and will not be tolerated,” said U.S. Attorney Gregory W. Kehoe. “This resolution sends a clear message to the provider community and our district that we will actively investigate and prosecute this fraudulent conduct whenever it appears.”

“Medicare enrollees depend on medical providers to bill honestly and provide only medically necessary services,” said Special Agent in Charge Isaac M. Bledsoe of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “When health care providers submit improper or inflated claims, they undermine the integrity of our federal health care programs and erode patient trust. Today’s resolution reflects our continued commitment to working with our law enforcement partners to hold providers accountable for improperly billing federal health care programs and to protect taxpayer funds.”

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Sheryl Turner, a former employee at Pulmonary Associates of Brandon. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned United States ex rel. Sheryl Turner v. Pulmonary Associates of Brandon, P.A., Case No. 8:23-cv-382-KKM-NHA (M.D. Fla). 

This matter was investigated by the U.S. Department of Health and Human Services - Office of Inspector General. It was handled by Assistant U.S. Attorney Kelley Howard-Allen.  

The claims resolved by the settlement are allegations only and there has been no determination or admission of liability by Pulmonary Associates of Brandon.

The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division. The core mission of the Fraud Division is to zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars. Department of Justice efforts to combat fraud support President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.