Breaking Legal News:  Whistle Blower Lawsuit Results in Medicare/TennCare/Medicaid Fraud Settlement of Four Million, Three Hundred Sixty Thousand Dollars ($4,360,000.00). For immediate release May 4, 2012:

David A. Burkhalter, II
Attorney
111 South Central Street
Knoxville, TN 37902
Phone:  (865) 524-4974
Fax:  (865) 524-0172
david@burkhalterrayson.com
www.burkhalterrayson.com

APEX MEDICAL GROUP, D/B/A NEPHROLOGY CONSULTANTS, NASEEMUL SIDDIQI, M.D., AND NADEEM SIDDIQI, EXTRACORPOREAL TECHNOLOGIES, AND FORT SANDERS KIDNEY CENTER, INC. OF KNOXVILLE, TENNESSEE, PAYS $4,360,000.00 TO SETTLE A WHISTLE BLOWER MEDICARE/TENNCARE/MEDICAID FRAUD SUIT.

Fraud exposed by Tennessee whistle blower

David A. Burkhalter, II, Attorney, Knoxville, Tennessee, represented the whistle blower

KNOXVILLE, TN. (May 4, 2012) – Apex Medical Group, d/b/a Nephrology Consultants, Naseemul Siddiqi, M.D., Nadeem Siddiqi, Extracorporeal Technologies, and Fort Sanders Kidney Center, Inc. entered into an agreement with the United States Department of Justice, the Office of the Inspector General of the Department of Health and Human Services, and the State of Tennessee to pay Four Million, Three Hundred and Sixty Thousand Dollars ($4,360,000.00) in settlement of a False Claims Act case filed in Federal Court for the Eastern District of Tennessee at Knoxville.

The settlement results from a suit filed by a Tennessee whistle blower under the qui tam provisions of the Federal False Claims Act, 31 U.S.C. § 3729, et. seq., and under the Tennessee Medicaid False Claims Act, T.C.A § 71-5-181, et. seq.

On July 25, 2005, the whistle blower, Kristi Moore, of Knoxville, Tennessee filed a forty-three (43) page Complaint in U.S. District Court for the Eastern District of Tennessee:  United States of America, State of Tennessee, ex. rel. Kristi Moore v. Apex Medical Group, PC, d/b/a Nephrology Consultants, Extracorporeal Technologies, Inc., Fort Sanders Kidney Center, Inc., NHS Development, LLC, et al; Case Nr.: 3:05-CV-367

The whistle blower was represented by Attorney, David A. Burkhalter of Knoxville, Tennessee.  “The False Claims Act qui tam provisions allow private parties to bring suits on behalf of the government where they have knowledge that the government has been cheated or defrauded,” Mr. Burkhalter said. “The Complaint was filed under seal to give the government time to conduct an investigation of the allegations in the complaint,” Mr.  Burkhalter said.

“Kristi, and whistle blowers like her, are true heroes when they decide to step forward and expose fraudulent practices that cost tax payers billions of dollars annually. Kristi, a former employee of Apex Medical Group, decided to file the case after she discovered the Defendants were hiding overpayments they had received from Medicare/Tenncare/Medicaid and were not refunding the overpayments, and were engaging in up coding and other fraudulent practices as alleged in the Complaint. She could have remained silent about these practices, but she had the courage to do something about it, and to say ‘enough is enough’– that makes her a hero in my book,” Burkhalter said.

The False Claims Act is also known as “The Lincoln Law” because it was originally passed during the Civil War to combat rampant fraud involving military sales to the government.  Federal and State False Claims Acts allow private citizens with knowledge of fraud to help the government recover ill-gotten gains and penalties.  These statutes allow the government to collect up to three times the amount of the False Claims, and in addition, civil penalties of $5,500 to $11,000 per false claim. Burkhalter noted that: “Whistleblowers, known as ‘qui tam relators’, can receive an award for exposing fraud.  In this case, Kristi will receive an award of $347,300.00 as a result of exposing the fraudulent practices.”   

To date, approximately $22 Billion Dollars has been recovered for the Government since the 1986 Amendments to the False Claims Act.  “Unfortunately, this is just the tip of the iceberg as law enforcement authorities estimate that healthcare fraud costs taxpayers more than $60 billion each year,” said Mr. Burkhalter.

The settlement was achieved through the efforts of the U.S. Attorney’s office for the Eastern District of Tennessee, including the efforts of Assistant U.S. Attorney, Elizabeth Tonkin, and the efforts of Peter Coughlin from the State of Tennessee Attorney General’s office.  Special Agents of the FBI, TBI, the Office of the Inspector General of Department of Health and Human Services, and the Tennessee Valley Authority Office of Inspector General also assisted in the investigation and prosecution of the case.  “They did an excellent job,” said Mr. Burkhalter.

Note:  Burkhalter, Rayson & Associates, P.C. is located in Knoxville, Tennessee and the firm is known for representing employees and injured parties, and whistleblowers in qui tam suits.  For more information, visit Burkhalter, Rayson & Associates, P.C.’s website at www.burkhalterrayson.com.  

Posted in News.