Consumer Fraud

Whistleblower Helps U.S. Recover Medicare Funds From Florida Doctor

Pills Stethascope on Money 435x289 Whistleblower Helps U.S. Recover Medicare Funds From Florida DoctorA whistleblower played an instrumental role in helping the U.S. government recover nearly $2 million for Medicare from her former employer, Sarasota physician Dr. Arthur S. Portnow, and his two medical practices.

According to the Middle District of Florida’s U.S. Attorney, the $1.95 million settlement concludes a lawsuit filed by Kathleen Siwicki under the whistleblower provisions of the False Claims Act, which entitles private parties to sue on behalf of the federal government in cases of suspected fraud against taxpayer-funded agencies and programs.

Ms. Siwicki worked as a certified cardiovascular technologist for Dr. Arthur S. Portnow, who owned and operated both Apple Medical and Cardiovascular Group and Apple Medical Group, the Tampa Bay Business Journal reported, citing the original lawsuit.

She started working for the practice in April 2014 and resigned on Nov. 14 of the same year after she witnessed “fraudulent documentation and fraudulent billing,” the whistleblower complaint said.

The U.S. Attorney’s office said that Dr. Portnow and his practice submitted fraudulent claims to Medicare for the evaluation and performance of medically unnecessary carotid ultrasounds, lower extremity arterial ultrasounds, abdominal aortic ultrasounds, renal and renal artery ultrasounds, and echocardiograms.

The government also alleges that Dr. Portnow falsified patient records to justify the unnecessary ultrasounds and received hundreds of thousands of dollars from the illicit tests.

According to federal prosecutors, the fraudulent activity occurred from August 2009 through August 2017.

Dr. Portnow’s settlement agreement also enters him into an integrity agreement with the U.S. Department of Health and Human Services.

“Physicians who seek to boost their profits by charging taxpayers and patients for medically unnecessary tests will be thoroughly investigated,” said Special Agent in Charge Shimon R. Richmond of the U.S. Health and Human Services, Office of the Inspector General. “Working in coordination with our law enforcement partners, we will continue to pursue health care professionals who threaten the integrity of federal health care programs.”

Under the U.S. False Claims Act, whistleblowers whose complaints lead to a recovery for the U.S. are awarded between 15 and 25 percent of the total recovery. The U.S. government said that Ms. Siwicki will receive a whistleblower award of about $350,000.