Missoula vascular surgeon settles alleged health care fraud claims for $3.7 million
MISSOULA – A Missoula vascular surgeon who operates vein and surgery centers in Missoula and Kalispell has agreed to pay the federal government $3.7 million to settle alleged False Claims Act violations that he performed medically unnecessary surgeries based on improper techniques and submitted fraudulent bills for payment to federal health care programs, U.S. Attorney Leif M. Johnson said today.
Dr. David Bellamah, and his business, Bellamah Vein & Surgery, PLLC, doing business as Bellamah Vein Center, has entered into a civil settlement agreement with the U.S. Attorney’s Office for the District of Montana, the Department of Health and Human Services Office of Inspector General, the Defense Health Agency, the Department of Veterans Affairs and a third party, Lenore Lezanne. The terms of the settlement agreement require Bellamah and his company to pay a settlement amount of $3,746,324. The settlement agreement resolves a civil complaint alleging violations of the False Claims Act and other common law claims. The civil complaint in intervention was filed today in U.S. District Court for the District of Montana along with a stipulation to dismiss the case.
“This civil settlement resolves claims of using improper techniques and unnecessary medical procedures to create and submit false claims to four federal health care programs. Submitting false claims for unnecessary procedures increases the cost of providing services to people who really need it. Had the United States known the truth, it would not have paid such claims. We will investigate and hold accountable medical providers who try to enrich themselves through false billing to federal health benefit programs. I want to thank our office’s health care fraud investigation team, the Department of Health and Human Services Office of Inspector General and the FBI for their work on this case,” U.S. Attorney Johnson said.
“Performing medically unnecessary surgeries risks the health and wellbeing of patients, compromises the integrity of federal health care programs, and increases the financial burden on taxpayers,” stated Curt L. Muller, Special Agent in Charge with the Department of Health and Human Services, Office of Inspector General. “Working closely with our partners, HHS-OIG will continue to safeguard the integrity of federal health care programs by investigating individuals who seek to exploit them.”
“David Bellamah’s alleged actions violated the oath held sacred by physicians,” said Special Agent in Charge Dennis Rice of the Salt Lake City FBI. “Health care fraud affects all Americans and the FBI remains committed to doing our part to combat it.”
The United States contended in court documents that its civil claims against Bellamah and his company arose from him billing for certain services that were medically unnecessary and based on false medical records from January 1, 2015 through March 31, 2017. Bellamah specializes in the diagnosis and treatment of venous reflux disease and varicose veins.
In March 2018, Lezanne, who was a sonographer formerly employed at Bellamah Vein Center, filed a suit in U.S. District Court against Bellamah Vein and Surgery, Bellamah and others alleging Bellamah received government funds for performing unnecessary venous procedures based on inaccurate medical records. The United States partially intervened in the case.
In its complaint, the United States alleged that Bellamah and staff at Bellamah Vein Center used improper techniques to conduct and analyze ultrasounds and used false ultrasound findings to conduct and bill for medically unreasonable and unnecessary services related to the diagnosis and treatment of venous reflux disease and varicose veins. The government contends that Bellamah submitted false claims to the Department of Health and Human Services’ Medicare and Medicaid programs, the Department of Defense’s TRICARE program and the Department Veterans Affairs’ CHAMPVA program.
The Settlement Agreement directs Bellamah to pay the United States $3,746,324, plus interest if applicable, of which $1,923,861 is restitution and the remaining $1,822,463 is settlement of additional damages. If the settlement amount is paid in full within 21 days of the effective date of the Settlement Agreement, no interest shall be charged. Otherwise, Bellamah shall make payments, plus interest, over five years. Upon receiving the settlement amounts, the United States will pay Lezanne 17 percent of each payment as her share of the settlement.
The Settlement Agreement is neither an admission of liability by Bellamah nor a concession by the United States that its claims are not well founded.
Assistant U.S. Attorney Michael A. Kakuk represented the United States in this matter, which was investigated by office’s health care fraud investigation team, the Department of Health and Human Services Office of Inspector General and the FBI, with additional assistance from the Defense Health Agency and the Department of Veterans Affairs Office of Inspector General.
PACER case reference. 18-57-M-DLC