Physicians group pays over $1M to resolve false billing claims
HOUSTON – Millennium Physicians Association PLLC has paid the United States $1,248,964 to resolve claims that they improperly billed the Medicare program for sleep studies, announced U.S. Attorney Ryan K. Patrick.
“Providers must adhere to the Medicare rules and regulations if they wish to participate in the program,” said Patrick. “The rules safeguard patients and keep providers accountable to taxpayers.”
“Providers using improperly credentialed technicians are cheating the taxpayers and may put beneficiaries at risk,” said Joseph Martin, Acting Special Agent In Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “Along with our law enforcement partners, we will continue to guard the integrity of government health care programs.”
Millennium is based in The Woodlands and owns and operates two sleep centers in the Houston area doing business as Millennium Respiratory & Sleep Disorder Specialists.
The investigation began following the Jan. 4, 2018, filing of a whistleblower lawsuit. Millennium employed the whistleblower who alleged the company conducted sleep studies without the presence of properly credentialed technicians.
Medicare rules and guidelines require that properly-trained and certified sleep technicians administer sleep studies. However, the investigation revealed that from Jan. 8, 2015, through March 13, 2019, Millennium improperly billed and received payment for sleep tests when they did not have the required personnel present.
Medicare rules and guidelines also require facilities to be accredited or certified by the America Academy of Sleep Medicine, Joint Commission or Accreditation Commission for Health Care Inc. Millennium self-reported that from 2011 through 2019, two of its sleep test facilities did not have such accreditation or certification.
The United States contended Millennium violated False Claims Act (FCA) by knowingly submitting, or causing to be submitted, false claims to Medicare for payment for sleep studies performed at these unaccredited sleep centers.
Under the FCA, a private party (relator) can file an action known as a qui tam on behalf of the United States and receive a portion of the recovery. In this case, the relator received $187,344 as a result of the settlement.
The U.S. Attorney’s Office, Department of Health and Human Services - Office of Inspector General and FBI conducted the investigation. Assistant U.S. Attorney Jill Venezia handled the matter.
The settlement resolved the claims without a determination of liability.