PITTSBURGH – Circulatory Centers of America, LLC, a Pennsylvania company that provided treatments for varicose veins in several states, together with related subsidiaries, its former owner and chief executive officer Thomas E. Certo, president David Gilpatrick, chief financial officer Everett Burns, and medical director Dr. Louis Certo, M.D., (collectively "Defendants"), agreed to pay the United States $1,205,000.00 to settle False Claims Act allegations, United States Attorney Scott W. Brady announced today.
The settlement resolves allegations in a whistleblower lawsuit filed in federal court in Pittsburgh, Pennsylvania. The United States contended that Defendants submitted claims to the Medicare program to receive reimbursement for services purportedly performed by non-physicians "incident to" the supervision of a physician when, in fact, no physician was present in the office. Billing services as "incident to" a physician’s supervision commands a higher reimbursement rate than billing those same services without physician supervision. The Complaint also alleged that Defendants submitted claims to the federal government for medically unnecessary and unreasonable ultrasound services performed by technicians who did not have the requisite license, certification, and/or training; and ultrasound services that were not actually provided.
"Inflating the cost of healthcare services defrauds taxpayers and depletes the limited funds available to provide medical care to deserving patients," said U.S. Attorney Brady. "Today’s settlement signals our commitment to aggressively pursue entities and individuals who attempt to cheat American taxpayers."
This matter was investigated by the Office of Inspector General of the Department of Health and Human Services and the Federal Bureau of Investigation. Assistant United States Attorneys Colin J. Callahan, Rachael L. Mamula and Jill L. Locnikar handled this matter on behalf of the United States.
This case is captioned United States ex rel. Paul Shields, et al. v. Circulatory Centers of America, LLC, et al., Civil Action No. 15-cv-229 (W.D. Pa.). The claims resolved by the settlement are allegations only, and there has been no determination of liability.