University of California Pays $1.2 Million to Settle Medicare Fraud Claims

The University of California will pay $1.2 million to settle a whistleblower’s claims that one of its teaching hospitals submitted false Medicare and Medicaid claims.

Dennis O’Connor, a former professor and anesthesiologist at U.C. Irvine (UCI), will receive $120,000 for his role in the case; the remainder goes to the U.S. government. In his lawsuit, Dr. O’Connor alleged that UCI routinely gave patients anesthesia without a doctor being present, in violation of federal requirements.

Dr. O’Connor sued UCI under the qui tam provision of the False Claims Act (FCA), which allows private parties to sue on behalf of the United States for fraudulent use of government funds, and to share in any recovery.  The government may intervene in the lawsuit, but has no obligation.

According to Dr. O’Connor, UCI hospital staff “pre-filled” reports to make it look like an anesthesiologist was present, even though sometimes no such doctor was in the building. UCI then got reimbursed by federal programs such as Medicare, in violation of the programs’ rules, the suit claimed.

UCI denied the charges, but also said it had retooled its anesthesiology program to make such violations impossible.

The UCI anesthesiology program has faced similar allegations before, according to the Los Angeles Times, and in 2008 the California Medical Board accused its former head of gross negligence and incompetence.

“I won’t go there,” Dr. O’Connor told the Times, “and I wouldn’t take my family there.”

The Employment Law Group® law firm’s whistleblower attorneys have helped many clients file suit against employers that fraudulently bill the U.S. government, and have established favorable precedents under the retaliation provision of the False Claims Act.

Tagged: False Claims Act (FCA), Fraud Types, Medicare Fraud, Whistleblower Laws (Federal)