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Radiology Medicare fraud case settled for $1.4 million

Seeger Weiss is pleased to announce a $1.4 million settlement resolving allegations that Florida radiology practice Mori, Bean, and Brooks, P.A. (MBB) violated the False Claims Act (FCA). The case was originally filed by whistleblower Thomas Heyck, represented by Seeger Weiss partner Shauna Itri. Heyck, who had worked for the Jacksonville-based practice as a radiologist, […]

July 1, 2020

Shauna Itri

Seeger Weiss is pleased to announce a $1.4 million settlement resolving allegations that Florida radiology practice Mori, Bean, and Brooks, P.A. (MBB) violated the False Claims Act (FCA). The case was originally filed by whistleblower Thomas Heyck, represented by Seeger Weiss partner Shauna Itri. Heyck, who had worked for the Jacksonville-based practice as a radiologist, alleged that MBB had knowingly submitted false claims to Medicare for radiological images not eligible for reimbursement. He sued under the qui tam, or whistleblower, provisions of the False Claims Act permitting a private citizen to sue on behalf of the United States for false claims and to share in the recovery.

The settlement is a result of close collaboration between the Justice Department and the relator’s counsel. “We made a good team,” Itri says. “My client was really able to help with the investigation.”

“The government wanted to sense a message with the enforcement of these regulations,” Itri added. “The defense was cooperative. Ultimately they came to a fair resolution.”

Between 2012 and 2019, MBB billed Medicare for radiological interpretations that were performed outside of the United States, though regulations require that these services must be performed within the country. MBB also billed for radiological interpretations initially performed outside of the United States that were then interpreted again by a U.S. radiologist, falsely indicating that the U.S. provider had conducted the original interpretation.

“Medicare only pays for services provided in accordance with Medicare rules,” said Special Agent in Charge Omar Perez Aybar of the U.S. Health and Human Services, Office of Inspector General. “Knowingly submitting false claims for financial gain is unacceptable. Today’s settlement should serve as a warning that anyone attempting to defraud taxpayer-funded health care programs will be vigorously pursued.”

After being informed of the investigation, MBB ceased the fraudulent billing practice and cooperated with the government to reduce the amount owed.

For well over a decade, Itri has led litigation teams in complex fraud cases in both state and federal courts. Itri’s nationwide practice has focused on representing plaintiffs in various settings — including securities and consumer class actions; antitrust; and cases involving patient harm. Itri also has extensive experience representing whistleblowers in False Claims Act lawsuits and other whistleblower programs throughout the United States. She has been honored by the Philadelphia Business Journal as one of the “Best of the Bar” and by The Legal Intelligencer as a “Distinguished Leader.”

Seeger Weiss has successfully represented relators in many qui tam proceedings. The firm served as relator counsel in United States ex rel. Alexander, et al. v. Warner Chilcott plc, et al., in which $125 million was recovered in connection with a sprawling healthcare scheme. The firm also was counsel to the whistleblower in People of the State of New York, ex rel. Vijay Tharwani v. Mohanbhai Ramchandani and Mohan’s Custom Tailors, Inc., which resulted in the recovery of $5.5 million in connection with a decade — long tax evasion scheme. From its offices in New York, New Jersey, and Pennsylvania, Seeger Weiss has represented over 10,000 individuals, companies, and governments across the U.S. who have been injured or defrauded on a massive scale.

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