Justice Department and CEO of Former Medical Laboratory Settle Civil Case Relating to False Claims Law and Anti-Recoil Law | USAO-WDWA
Seattle – A civil case under the False Claims Act / Anti-Recoil Law was resolved today with an agreed payment of $ 1.1 million by the former general manager of a medical testing lab today ‘hui disappeared, announced the United States Attorney Nicholas W. Brown. Jae Lee, 50, of Bellevue, Wash., Was CEO of the Northwest Physicians Laboratory (NWPL) from January 1, 2013 until July 30, 2015. Lee agreed to pay $ 500,000 within 30 days of the settlement agreement, with additional payments. annually until full payment.
“The resolution of this civil case, as well as Mr. Lee’s guilty plea in the criminal case last year, are major milestones in this health care fraud investigation,” the prosecutor said. American Brown. “The anti-recoil law aims to protect the public by preventing fraud from inflating our health care costs. When, as in this case, a whistleblower brings fraud to our attention, the US attorney’s office will vigorously pursue an investigation. “
The settlement with Jae Lee is the third of its kind involving the bribe program and NWPL. In July 2020, the US Department of Justice reached a $ 12 million settlement with Sterling Healthcare Opco, LLC d / b / a / Cordant Health Solutions (Cordant) of Tacoma and Denver. In December 2018, in Vancouver, Wash., Testing lab MTL agreed to pay $ 1,777,738 to settle allegations that it violated the False Claims Act by paying illegal bribes. for references to government health insurance programs.
Under these regulations, and the one signed today with Jae Lee, between January 2013 and July 2015, MTL and Sterling / Cordant both made payments to NWPL in exchange for referrals from Medicare and TRICARE program activities, in violation of the anti-recoil law. . Paying compensation to medical providers or provider-owned laboratories in exchange for referrals encourages providers to order medically unnecessary services. Part of the function of the False Claims Act and anti-kickback law is to discourage such behavior. NWPL was owned by doctors and, for this reason, could not test urine samples for patients covered by government health programs such as Medicare, Medicaid, and TRICARE. In order to conceal the payment of the bribes, MTL, Sterling / Cordant and NWPL described the charges as marketing services; however, no marketing service was provided.
“Paying or accepting bribes defeats the goals of federal health care programs,” said Steven Ryan, special agent in charge of the Office of the Inspector General of the US Department of Health. Health and Social Services. “Providers are trusted to select patient services based on medical necessity and good judgment, not greed. Eliminating bribes in these programs remains a top priority for our agency and our partners. “
“The announced settlement concludes a multi-year civilian inquiry that clearly demonstrates the government’s commitment to hold accountable those whose actions have tainted the integrity of federal health programs, including the Department of Defense’s TRICARE program,” said Bryan D. Denny, Special Agent in Charge. for the Office of the Inspector General of the Ministry of Defense, Defense Criminal Investigation Service (DCIS), Western Field Office. As illustrated in this case, DCIS will continually work with its law enforcement partners to defend against questionable business practices in order to protect taxpayer dollars and the health care interests of our military and their members. families, as well as the American public. “
In this case, the whistleblower will receive 15% of the funds, as is customary in the qui tam law.
The criminal case concerning the bribe system is still ongoing. Richard Reid, 52, of Astoria, Oregon, Kevin Puls, 56, of Bellevue, is due on trial in January 2022. Former NWPL CEO Jae Lee and MTL vice president Steve Verschoor, pleaded guilty and are expected to be sentenced in March 2022. NWPL as a legal entity was sentenced in May 2021 and ordered to pay $ 8,114,417 in joint and several damages with the other defendants.
The case is under investigation by the FBI, the Office of the Inspector General of Health and Human Services (HHS-OIG) and the Defense Criminal Investigation Service (DCIS).
The civil case was handled by Assistant United States Attorney Kayla Stahman.