Chicago Health Care Company and Its Owner To Pay $1 Million To Settle False Claims Act Lawsuit

CHICAGO — A Chicago health care company and its owner will pay $1 million to the United States to resolve a civil lawsuit arising from the submission of false claims to Medicare. 

BRIAN J. WEINSTEIN and APOLLO HEALTH INC. violated the False Claims Act by submitting claims to Medicare for care plan oversight services that were not actually performed, according to a consent judgment and settlement agreement filed in U.S. District Court in Chicago.  Care plan oversight services (“CPO”) involve a physician’s supervision of a patient receiving complex or multidisciplinary medical care.  At Weinstein’s direction, Apollo’s billers submitted 12,592 claims for CPO services on behalf of 25 providers purportedly employed by Apollo.  Weinstein knew that the providers had not actually provided CPO services to Medicare patients and that CPO services had not been documented in the patients’ medical records.

As part of the consent judgment and settlement agreement entered this week by U.S. District Judge Sharon Johnson Coleman, Weinstein and Apollo agreed to pay $1 million to the United States.  The consent judgment and settlement agreement resolve a civil lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act.  The Act permits private citizens to bring lawsuits on behalf of the United States for false claims, and to share in any recovery.  The United States intervened in the lawsuit prior to the settlement.

The consent judgment and settlement were announced by Morris Pasqual, Acting United States Attorney for the Northern District of Illinois, Mario Pinto, Special Agent-in-Charge of the U.S. Department of Health and Human Services, Office of the Inspector General, and Robert W. “Wes” Wheeler, Jr., Special Agent-in-Charge of the Chicago Field Office of the FBI.  The government was represented by Assistant U.S. Attorney Virginia Hancock.

In a separate criminal prosecution, Weinstein pleaded guilty last year to a federal health care fraud charge and was sentenced to three years of probation.