Tampa Pain Management Physician Edward Lubin Agrees To Pay $1.5 Million To Settle False Claims Act Liability For Receiving Bribes And Writing Unnecessary Fentanyl Prescriptions
Orlando, FL – United States Attorney Roger B. Handberg announces today that Jena Medical Group, LLC, Benjamin Weiss, Moishe Hoffman, and Jason Schultz have agreed to pay the United States $1,724,986.08 to resolve allegations that they violated the False Claims Act by submitting claims to Medicare and TRICARE for radiofrequency ablations that were performed by an unqualified technician.
According to the settlement agreement, Jena Medical, through its principals, Benjamin Weiss, Moishe Hoffman, and through Dr. Jason Schutlz, billed Medicare and TRICARE for radiofrequency ablations that were not medically necessary, not provided by a qualified provider, or both, during the period from January 1, 2018, through December 31, 2020. According to the allegations, patients referred to the unqualified technician as “doctor” and were led to believe he was qualified to perform their procedures. Jena Medical also permitted the washing and re-use of catheters that were designed for a single use.
“Protecting Medicare and TRICARE patients is paramount,” said U.S. Attorney Roger Handberg. “This civil settlement demonstrates our continuing commitment to hold accountable those who abuse the nation’s healthcare programs at the expense of the taxpayers.”
“Allegations of health care providers billing our federal health care programs for unnecessary services is of deep concern, especially if such services could potentially cause harm to patients,” stated Acting Special Agent in Charge Julie Rivera of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Working with our law enforcement partners, we will continue to protect the health of patients and the integrity of the federal health care programs serving them.”
“When actors within our health care system are focused on profit rather than patient care, it undermines the integrity of the medical decision-making process,” stated Special Agent in Charge Darrin K. Jones, DoD Office of Inspector General, Defense Criminal Investigative Service (DCIS), Southeast Field Office. “ DCIS will continue to work with our investigative partners to protect the funding entrusted to the Defense Health Agency which serves our military members and their families.”
The settlement concludes a lawsuit originally filed in the United States District Court for the Middle District of Florida by Relator Michael Lomonaco, a Doctor of Nursing Practice and former employee of Jena Medical. Dr. Lomonaco sued under the qui tam, or whistleblower, provisions of the False Claims Act permitting private citizens to sue on behalf of the United States for false claims and to share in the recovery. The Act also allows the United States to intervene and prosecute the action. The Relator will receive over $300,000 of the proceeds from the settlement with the defendants.
This settlement resulted from a coordinated effort by the U.S. Attorney’s Office for the Middle District of Florida, the HHS Office of Inspector General, and the Defense Criminal Investigative Service. Assistant United States Attorney Jeremy R. Bloor led the investigation.
The government’s action in this matter illustrates the emphasis on combating health care fraud, and one of the most powerful tools in this effort is the False Claims Act. Tips 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).
The case is captioned United States ex rel. Lomonaco v. Jena Medical Group, LLC et al., Case No. 6:20-cv-312-ORL-WWB. The settlement resolves the United States’ claims in that case. The claims resolved by the settlement are allegations only, and there has been no determination of liability.