Medical assistant resolves false claims act allegations

ATLANTA – Robert Gennaro, a medical assistant, has agreed to be excluded from federal healthcare programs for a period of 10 years to resolve allegations that he impersonated a physician when providing remote surgical monitoring services, causing the submission of false claims to the federal government. The effect of the exclusion is federal healthcare programs will not make any payments to Gennaro, or anyone who employs him, for any services provided by Gennaro.

“Gennaro put patients at risk by impersonating a physician when remotely monitoring the neurological health of patients during surgery,” said U.S. Attorney Byung J. “BJay” Pak. “Gennaro will now be excluded from participating in all federal healthcare programs for 10 years.”

“The health and safety of the public is a high priority for law enforcement,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health & Human Services, Office of Inspector General in Atlanta.  “Anyone who puts monetary gains above health and safety will be held accountable.”

“Not only did Gennaro put patients at risk, but his actions threatened the integrity of our healthcare system at the expense of honest citizens,” said David J. LeValley, Special Agent in Charge of FBI Atlanta. “The FBI is determined to protect our citizens, and root out waste and abuse.”

The government alleges that Gennaro caused the submission of false claims to Medicare, TRICARE, and Federal Employee Health Benefit Plans for the online, real- time intraoperative monitoring of surgeries he observed (even though he is not a physician) and he falsely represented the surgeries had been monitored by Dr. Robert Windsor during the period from March 1, 2009 through July 31, 2013. Dr. Windsor was sentenced to three years, two months in federal prison followed by three years of supervised release in connection with his role in the scheme.  Windsor also entered into a consent judgment with the U.S. for $20 million, settling the intraoperative monitoring conduct and allegations that he and his pain management clinics performed medically unnecessary diagnostic tests.

The settlement resolves a lawsuit filed in the U.S. District Court for the Northern District of Georgia by Kris Frankenberg under the qui tam, or whistleblower, provisions of the False Claims Act. United States ex rel. Frankenberg v. Windsor et al., No. 1:12-cv-3114 (N.D. Ga.). Under the Act, private citizens can bring suit on behalf of the government for false claims and share in any recovery.

This settlement highlights a powerful tool to protect federal healthcare programs and beneficiaries and to hold accountable those who commit healthcare fraud—the exclusion authority of the U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG). Section 1128 of the Social Security Act gives HHS-OIG the authority to exclude individuals and entities from participation in federal healthcare programs for fraud or other misconduct.

The claims resolved are allegations only, and there has been no determination of liability.  

This case was investigated by the U.S. Attorney’s Office for the Northern District of Georgia, the U.S. Department of Health & Human Services Office of Inspector General, the Federal Bureau of Investigation, and the Defense Criminal Investigative Service.

The civil settlement was reached by Assistant U.S. Attorney Lena Amanti.

For further information please contact the U.S. Attorney’s Public Affairs Office at USAGAN.PressEmails@usdoj.gov or (404) 581-6016.  The Internet address for the U.S. Attorney’s Office for the Northern District of Georgia is http://www.justice.gov/usao-ndga.