Whistle Blower Is Rewarded For Uncovering Medicare Fraud

Dr. Steven Stern and his Kentuckiana Center for Better Bone and Joint Health (KCB) practice have agreed to pay $349,860 to settle an overfilling of Medicare allegation.

Suzette Sewell-Scheuremann, a former employee of the Kentuckiana Center for Better Bone and Joint Health, alleged that Stern and his practice billed Medicare for infusing Infliximab which is a drug used to treat arthritis. The former employee’s complaint claims that Stern and the practice we splitting vials of the drug across multiple patients and billing Medicare as if an entire vial was used for each patient. Apparently this was claimed to happen over a three year period from December of 2003 until December of 2006.

“Physicians and other providers who overbill Medicare defraud the government and drive up the cost of health care for us all,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “Recovering taxpayer dollars lost to fraud helps keep strong those critical public health care programs so many people depend on.”

“This case illustrates the importance and value of whistleblower lawsuits under the False Claims Act,” said United States Attorney David Hale. “Because this employee stepped forward to report suspected double-billing of Medicare, we have been able to stop a practice that we believe was costing taxpayers hundreds of thousands of dollars. Pursuing health care and Medicare fraud is a priority of my Office and the Department of Justice. We will continue to work with the Department of Health and Human Services and the public to ensure that fraudulent claims are investigated and those responsible are required to pay.”

“Overbilling Medicare – as the government alleged in this case – is no more to be tolerated than pick pocketing taxpayers’ wallets,” said Derrick Jackson, Special Agent in Charge of the Atlanta Region for the Office of Inspector General of the Department of Health and Human Services. “Along with our law enforcement partners we will bring justice to those who see government health programs as nothing more than personal piggy banks.”

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Stern will pay the agreed settlement amount as well as attorney’s fees, costs and expenses of Sewell-Scheuremann for filing the complaint . Sewell-Scheuremann will receive a payment of $70,000 as a relator’s share of this case since she brought this fraudulent activity into light –Source.

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