U.S. v. Acadiana Cardiology (Summary)

FALSE CLAIMS ACT

U.S. v. Acadiana Cardiology, Civil Action No. 04-732 (W.D. La. Mar. 31, 2014)

The U.S. District Court for the Western District of Louisiana denied a cardiologist’s and his cardiology center’s partial motion for summary judgment on an individual’s (“relator”) qui tam action under the federal False Claims Act (“FCA”).  The relator, a former employee of the center, alleged that the cardiologist and center performed, and billed federally funded health care programs for, unnecessary, improper, and excessive medical services.  Defendants moved that the government lacked the CMS Form 1500s to show that any bills were submitted to Medicare for the pertinent procedures.  The court held that, in an FCA case, documentation other than a CMS Form 1500 can serve as sufficient circumstantial evidence that a claim was submitted to Medicare, including testimony that establishes that false claims were submitted.