Dr. Arthur S. Portnow, the owner and operator of Arthur S. Portnow, P.A., a medical practice based in Sarasota, Florida, has agreed to pay $1.95 million to resolve allegations that he and his practice violated the False Claims Act by knowingly seeking reimbursement for medically unnecessary ultrasound tests that were performed on Medicare beneficiaries.
This settlement is the result of a qui tam, or whistleblower, lawsuit filed by a former employee of Dr. Portnow’s practice. The qui tam provisions of the False Claims Act permit private individuals with knowledge of fraud against the federal government to sue on behalf of the government and share in any recovery. Ms. Kathleen Siwicki, a Certified Cardiovascular Technologist and the whistleblower in this case will receive approximately $350,000 as her share of the settlement for exposing Dr. Portnow’s fraud. The False Claims Act also allows the Department of Justice to intervene in a whistleblower’s lawsuit and take over prosecution of the action.
In Ms. Siwicki’s Complaint, she alleged that she became aware of unusual patient care practices within the first few days of her employment including repetitive ultrasound tests when previous test results were normal and certain ultrasound test always being performed regardless of patient need. Ms. Siwicki also alleged that she was instructed to assign predetermined billing codes and diagnoses prior to even seeing patients in order to maximize reimbursement.
In this case, the government alleged that from August 2009 through August 2017, Dr. Portnow submitted fraudulent claims to Medicare for the evaluation and performance of medically unnecessary carotid ultrasounds, lower extremity arterial ultrasounds, abdominal aortic ultrasounds, renal and renal artery ultrasounds, and echocardiograms. The government also alleges that Dr. Portnow falsified patient records in an effort to justify those unnecessary ultrasounds. Dr. Portnow and his practice received hundreds of thousands of dollars as a result of this illicit testing.
“Physicians who seek to boost their profits by charging taxpayers and patients for medically unnecessary tests will be thoroughly investigated,” said Special Agent in Charge Shimon R. Richmond of the U.S. Health and Human Services, Office of the Inspector General. “Working in coordination with our law enforcement partners, we will continue to pursue health care professionals who threaten the integrity of Federal health care programs.”
“Fraudulently billing the government for medically unnecessary tests deprives federal health care programs, like Medicare, of valuable resources,” said Acting U.S. Attorney W. Stephen Muldrow of the Middle District of Florida. “This settlement is evidence that our office will continue to pursue those who seek to unlawfully exploit our nation’s federal health care programs at the expense of patients and the Federal Treasury.”
Frohsin Barger & Walthall would like to thank and congratulate the U.S. Attorney’s Office for the Middle District of Florida, Assistant United States Attorney Christopher Tuite and HHS-OIG for their efforts in recovering nearly $2 million for the United States taxpayers. Frohsin Barger & Walthall would also like to thank and congratulate Kathleen Siwicki, the whistleblower that brought this case to the government’s attention, as well as Ms. Siwicki’s counsel Morgan & Morgan of Tampa, Florida for their role in prosecuting this action.
To learn more about the qui tam provisions of the False Claims Act, please contact Frohsin Barger & Walthall.