The U.S. District Court for the District of Columbia has entered judgment for more than $17 million against Dr. Ishtiaq Malik and his two companies, Ishtiaq Malik M.D., P.C. and Advanced Nuclear Diagnostics, for submitting false nuclear cardiology claims to federal and state health care programs, the U.S. Department of Justice announced last month.
The government’s allegations focused on Dr. Malik’s inappropriate claims for myocardial perfusion studies, commonly referred to as nuclear stress tests, which are used to determine whether a patient has heart disease. The test is usually performed in two separate phases: stress and rest. The two phases, which can be conducted on the same day or separate days, must be billed as one test. The government alleged that, contrary to these requirements, Dr. Malik and his companies double-billed for multi-day nuclear stress tests.
The government alleged that Dr. Malik submitted false claims to Medicare, District of Columbia Medicaid, Maryland Medicaid, TRICARE and the Federal Employees Health Benefits Plan. In addition, the government alleged that Dr. Malik and his companies billed for services not performed as well as services already included in the payment for nuclear stress test codes, such as intravenous injections, drug infusions, 3D rendering and drug administration.
The government filed suit against Dr. Malik and his two companies under the False Claims Act, which allows the government to recover three times its damages, plus penalties, from those who submit false claims for federal funds. The state of Maryland and the District of Columbia subsequently joined the lawsuit under their respective state false claims acts. Private citizens with knowledge of fraud against the government can also sue on the government’s behalf and claim a share in the recovery.
The Obama administration has made a priority of preventing fraud and recovering losses, resulting in record recoveries for two years in a row. Fiscal year 2011 saw $3 billion recovered in False Clams Act cases, with $2.4 billion of that being cases of fraud committed against federal health care programs. Fiscal year 2012 saw $5 billion recovered in False Claims Act cases, with over $3 billion of that stemming from health care fraud cases. In both years, a vast majority of the cases were initiated by lawsuits filed by private citizens under the qui tam, or whistleblower, provisions of the False Claims Act. A record 647 qui tam cases were filed last fiscal year.
The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments. We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud. Read more about our expertise in False Claims Act cases and how you can take action.