Government Intervenes in False Claims Lawsuit Against IPC the Hospitalist Co. Inc. Alleging Overbilling of Physician Services
Seattle Whistleblower Attorneys report that the government has intervened in a lawsuit against IPC The Hospitalist
Co. Inc., and its subsidiaries (IPC), alleging that IPC submitted false
claims to federal health care programs, the Justice Department announced
today. IPC, based in North Hollywood, Calif., is one of the largest
providers of hospitalist services in the United States, employing
physicians and other health care providers who work in more than 1,300
facilities in 28 states. Hospitalists are physicians who work only in
hospitals and other long-term care facilities, overseeing and
coordinating inpatient care from admission to discharge.
The lawsuit alleges that IPC physicians sought payment for higher and
more expensive levels of medical service than were actually performed – a
practice commonly referred to as “upcoding.” Specifically, the lawsuit
alleges that IPC encouraged its physicians to bill at the highest
levels regardless of the level of service provided, trained physicians
to use higher level codes and encouraged physicians with lower billing
levels to “catch up” to their peers.
“We continue to be vigilant in our enforcement efforts to ensure that health care programs funded by the taxpayers pay only for appropriate costs,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery.
The lawsuit was filed by Dr. Bijan Oughatiyan, a former IPC physician, under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue for false claims on behalf of the government and to share in any recovery. The Act also allows the government to intervene or take over the lawsuit, as it has done in this case, and to recover three times its damages plus civil penalties. The government has asked the U.S. District Court in Chicago for 120 days to file its own complaint stating its allegations.
The case was investigated by the Commercial Litigation Branch, Civil Division, U.S. Department of Justice and the U.S. Attorney’s Office for the Northern District of Illinois, with assistance from the Department of Health and Human Services Office of Inspector General. The case is captioned United States ex rel. Oughatiyan v. IPC The Hospitalist Company Inc., et al., Civ. No. 09 C 5418 (N.D. Ill.). The claims asserted against IPC are allegations only; there has been no determination of liability.
Source: Dept. of Justice
“We continue to be vigilant in our enforcement efforts to ensure that health care programs funded by the taxpayers pay only for appropriate costs,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery.
The lawsuit was filed by Dr. Bijan Oughatiyan, a former IPC physician, under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue for false claims on behalf of the government and to share in any recovery. The Act also allows the government to intervene or take over the lawsuit, as it has done in this case, and to recover three times its damages plus civil penalties. The government has asked the U.S. District Court in Chicago for 120 days to file its own complaint stating its allegations.
The case was investigated by the Commercial Litigation Branch, Civil Division, U.S. Department of Justice and the U.S. Attorney’s Office for the Northern District of Illinois, with assistance from the Department of Health and Human Services Office of Inspector General. The case is captioned United States ex rel. Oughatiyan v. IPC The Hospitalist Company Inc., et al., Civ. No. 09 C 5418 (N.D. Ill.). The claims asserted against IPC are allegations only; there has been no determination of liability.
Source: Dept. of Justice