Daniel Purnell’s whistleblower lawsuit alleged that American Sleep Medicine billed Medicare, TRICARE, and the Railroad Retirement Medicare Program for sleep diagnostic services that were performed by technicians who lacked the required credentials and certifications.
Under federal program requirements for reimbursement of sleep disorder testing, initial sleep studies must be conducted by technicians who are licensed or certified by a state or national credentialing body as sleep test technicians. A claim for reimbursement is considered a “false claim” if the testing was conducted by a technician who is not licensed or certified.
Mr. Purnell brought the lack of certification to the attention of the government by filing a qui tam lawsuit under the False Claims Act. The law allows private citizens with knowledge of fraud to start a lawsuit on behalf of the United States and share in any recovery. The individual who files the lawsuit is known as a “relator.”
The lawsuit is initially filed “under seal” (in secret) to give the government time to conduct an investigation before the defendant knows that they are the target of a Medicare fraud investigation.
After conducting an investigation, the government intervened in Mr. Purnell’s lawsuit and negotiated a settlement. Under the terms of the settlement, American Sleep Medicine will pay $15,301,341 to resolve allegations that it billed Medicare, TRICARE – the health care program for Uniformed Service members, retirees and their families worldwide – for services that were not eligible for reimbursement.
Mr. Purnell will receive $2,601,228 as his whistleblower reward for alerting the government and bringing the lawsuit.
If you are aware of false claims being submitted to Medicare, Medicaid or another government program, then you should consult with an experienced False Claims Act attorney immediately to protect your rights. You may be eligible for legal protections as a whistleblower and a significant reward.
To arrange a free and confidential consultation, call John Howley, Esq. at (917) 652-6504 or click here to reach our offices via email.
John Howley, Esq.
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