Company and Owner Pay to Resolve Allegations

Posted on September 7, 2022Comments Off on Company and Owner Pay to Resolve Allegations

Colorado Springs Company and Owner Pay $400,000 to Resolve Allegations That They Submitted False Claims For Aquatic Therapy

(STL.News) The United States Attorney’s Office for the District of Colorado announced today that Dynamic Physical Therapy, LLC (“Dynamic”), a physical therapy company, and its owner, Emad Yassa, have agreed to pay the United States $400,000 to resolve allegations that they violated the False Claims Act by falsely billing federal health care programs for aquatic therapy services.

Dynamic is a physical therapy company that operates two clinics in Colorado Springs, Colorado. Dynamic is owned by Mr. Yassa, who also practices as a physical therapist at the Dynamic clinics. Dynamic submitted bills for physical and aquatic therapy services to Medicare and other federal health care programs.

In 2019, a former employee of Dynamic filed a sealed civil “whistleblower” lawsuit under the False Claims Act alleging that Dynamic, at the direction of Mr. Yassa, was billing Medicare for medically unnecessary physical therapy services and for services that had not actually been provided. The lawsuit was filed in federal district court in Colorado under the “qui tam,” or whistleblower, provisions of the False Claims Act.

Those provisions permit private parties to sue on behalf of the United States to bring claims based on the submission of false claims to the government and allow the whistleblower to receive a share of any funds recovered through the lawsuit. The whistleblower provisions encourage people with knowledge of fraud against the federal government to come forward when they believe fraud is being committed.

After the whistleblower complaint was filed, Mr. Yassa signed a “Stipulation and Final Board Order” with the State of Colorado’s Physical Therapy Board In the stipulation, Mr. Yassa admitted that, from mid-2014 to mid-2017, he “routinely and improperly billed insurance companies, Medicare, and Medicaid for individual aquatic therapy sessions for his patients when they had actually participated in group aquatic therapy sessions,” and also “routinely failed to document in his patients’ records that they had participated in group aquatic therapy sessions.”

In an investigation, the United States uncovered evidence indicating that Dynamic had also submitted false claims to TRICARE, a health care program for uniformed service members, retirees, and their families. The evidence indicated that Dynamic had falsely represented to TRICARE that its physical therapy services had been provided by an authorized physical therapy provider, when, in fact, they had been provided by an unauthorized physical therapy assistant.

The resolution obtained in this matter was the result of a coordinated effort between the U.S. Attorney’s Office for the District of Colorado, the Department of Health and Human Services – Office of the Inspector General, the Defense Criminal Investigative Service, and the Federal Bureau of Investigation.

“We will aggressively pursue any kind of health care provider who relies on fraud to obtain payments from our federal healthcare programs,” said U.S. Attorney Cole Finegan. “We also appreciate the efforts of whistleblowers who bring fraudulent billing practices to light.”

“Medicare monies for physical therapy are intended to support services that restore function, improve mobility, and relieve pain for beneficiaries,” stated Special Agent in Charge Curt L. Muller with the U.S. Department of Health and Human Services Office of Inspector General. “Our agency and law enforcement partners readily employ our resources to identify and investigate billing that diverts crucial funds inappropriately from federal health care programs.”

“The Department of Defense, Office of Inspector General, Defense Criminal Investigative Service (DCIS), along with our law enforcement partners, will diligently investigate individuals and companies that pilfer taxpayer resources and degrade the quality of the health care provided to America’s warfighters,” said Michael Mentavlos, Special Agent in Charge, of the DCIS Southwest Field Office. “Today’s outcome reflects DoD’s commitment to hold those who commit fraud against TRICARE and other U.S. Government healthcare programs accountable.”

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SOURCE: USDOJ.Today

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