Norman Regional Health System accused of billing fraud
The federal government is planning to pursue civil action against the Norman Regional Health System, six radiologists and the hospital’s former chief operating officer following an investigation into fraud allegations.
The fraudulent billing allegations were brought to the government’s attention through a multimilliondollar whistleblower’s lawsuit filed under seal in August 2014 by Dr. Lance Garber, a radiologist who worked for the hospital system from 2008 until March 2012.
Garber’s complaint, which was ordered unsealed Tuesday, alleges that radiology practitioner assistants performed medical procedures “without the required supervision of radiologists,” and that Medicare and other federal programs were subsequently fraudulently billed for those services.
The lawsuit, filed by the Andrews Davis law firm, said the precise amount of loss from the alleged fraud “cannot presently be determined,” but estimated potential financial damages and civil penalties would amount to “millions of dollars.”
Garber alleges that former Chief Operating Officer Greg Terrell “was made aware as early as 2008 that the radiologists and Norman Regional Hospital System were billing Medicare for radiology practitioner assistants’ services that were performed without the required level of supervision,” but “abdicated his responsibility and authority to prevent or correct the false billings.”
Named as defendants in the lawsuit along with Terrell and the Norman Regional Health System were radiologists Chadwick Webber, Merl Kardokus, Rick Wedel, Gautham Dehadrai, Barbara Landaal and Sanjay Narotam.
Melissa Herron, public relations coordinator for the Norman Regional Health System, said Wednesday that it is the hospital system’s general policy “not to comment on pending litigation.”
“Norman Regional Health System and its employees are dedicated to compliance with applicable laws, and will cooperate with the U.S. attorney’s office to resolve the matter,” Herron said.
The allegations in Garber’s complaint did not become public until Tuesday when U.S. District Judge Stephen P. Friot ordered the complaint unsealed.
Friot issued his ruling shorty after government attorneys disclosed their intention to file their own lawsuit to recover funds through provisions of the federal False Claims Act. That lawsuit is expected to be filed within 60 days.
The earlier federal whistleblower’s lawsuit filed by Garber is called a qui tam complaint.
It was filed under a federal law that provides financial incentives to encourage individuals with knowledge of government frauds to disclose that information without fear of reprisal or government inaction.
In qui tam court actions, individuals can file lawsuits in behalf of themselves and the government to recover funds lost to fraud. Persons found to have committed fraud can be assessed penalties ranging from $5,500 to $11,000 per false claim plus three times the amount of damages sustained by the federal government.
Any money recovered through such lawsuits is split between the individuals who filed the lawsuits and the government.
Government attorneys have the option of taking over such cases, filing their own complaints following investigations, dismissing complaints, or allowing the individuals who file such lawsuits to continue pursuing them on their own, said Bob Troester, spokesman for the U.S. attorney’s office in Oklahoma City.
In cases where the federal government takes over litigation, the original whistleblower typically receives 15 to 25 percent of any money recovered, while they receive higher percentages when they must pursue the cases on their own, he said.
When fraud is claimed, the allegations are typically reviewed for potential criminal charges, as well, Troester said. However, he said it is not unusual for government attorneys to pursue a fraud claim through civil litigation without criminal charges ever being filed.