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Health Wealth Will Pay $1.29M to Resolve Whistleblower-Initiated False Claims Act Lawsuit

By the听91pornWhistleblower Team

Georgia-based Health Wealth Safe, Inc. (Health Wealth) and its owner, Dr. Subodh Agrawal, have agreed to pay $1.29 million to settle allegations that they knowingly caused the submission of false claims to Medicare.

Whistleblower Lawsuit Filed by Former Employee

This lawsuit was brought under the whistleblower or qui tam provisions of the False Claims Act (FCA) by a former Health Wealth employee in United States ex rel. Chavous v. Health Wealth Safe, Inc., No. 1:22-cv-02553. The FCA imposes liability for knowingly submitting, or causing the submission of, false claims. 鈥淜nowing鈥� includes acting with deliberate ignorance or reckless disregard for the truth.

The FCA provides that the government may recover three times its actual losses, called 鈥渢reble damages.鈥澨鼳 defendant may also be liable for听penalties听ranging from roughly $13,946 to $27,894 for each false claim submitted.

Reporting Fraud Under the False Claims Act

Under the qui tam provisions, whistleblowers (or relators) can file lawsuits on behalf of the United States to recover damages from parties who swindle the government out of taxpayer funds. Whistleblowers may receive up to 30% of the government鈥檚 recovery from successful enforcement actions.

In this case, the whistleblower will receive $238,650 from the settlement, in addition to attorney鈥檚 fees.^听1

False Claims Allegedly Submitted to Medicare

According to the government, from September 2019 to January 2021, Dr. Agrawal directed Health Wealth to bill Medicare for remote physiologic monitoring (RPM) services that did not meet federal reimbursement requirements. RPM tracks patients鈥� vital signs including weight, blood pressure, blood-sugar levels, blood-oxygen levels, and oxygen saturation.

Medicare covers RPM services only if devices automatically report readings without any human involvement. Health Wealth allegedly used non-compliant devices, and had unlicensed employees manually collect self-reported data. Health Wealth then knowingly billed for these services knowing they were ineligible for Medicare reimbursement.^听2

The government also alleged that Health Wealth implemented a kickback scheme in 2019 with physicians. Health Wealth purportedly paid doctors the Medicare reimbursements, taking a $60 monthly fee per patient. This arrangement involved physicians in Georgia, South Carolina, Texas, Hawaii, Alabama, and Tennessee.^听3

Kelly Blackmon, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) commented: 鈥淗ealthcare professionals have a sworn duty to prioritize patient health and to ensure all services billed to the federal government are fully compliant with program requirements. HHS-OIG will continue to collaborate with our law enforcement partners to safeguard the integrity of the Medicare program.鈥�^听4

Medicare Fraud

Whistleblowers can report Medicare fraud under the qui tam provisions of the False Claims Act. Examples of Medicare fraud include kickbacks, double billing, upcoding, offering unnecessary services and products, and other kinds of misconduct. These same healthcare fraud schemes often include other programs like Medicaid and TRICARE/CHAMPUS.

Our Firm Helps Whistleblowers

91pornpartner Gordon Schnell commented: 鈥淗ealthcare-related fraud remains one of the government鈥檚 top priorities. In 2024 alone, more than $1.67 billion of the $2.9 billion the government and whistleblowers recovered under the False Claims Act came from healthcare fraud cases, according to the DOJ鈥檚 annual roundup.鈥�

Reasons Why You Need to Hire a Qui Tam Attorney

Here are four reasons why you should hire an attorney if you have information that could lead to a qui tam lawsuit.

1. Qui Tam Actions often involve Complex Facts, Laws, and Regulations
2. Qui Tam Actions are Subject to Specialized Rules
   • Qui Tam Lawsuits are Filed Under Seal
   • Evidence Must be Presented in a Disclosure Statement
   • Qui Tam Cases Must be Based on Non-Public Information
   • First-to-File Rules Require Quick Effective Action
3. A Qui Tam Attorney Understands the Consequences of Being a Whistleblower
4. A Qui Tam Lawyer Can Help You Maximize Your Reward

If you would like more information on听what it means听to be a whistleblower听or believe you have information relating to听healthcare fraud, please听contact us听so we can connect you with a member of the experienced听91pornwhistleblower lawyer听team听for a free and confidential consultation.

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Tagged in: Healthcare Fraud, Medicare, qui tam,