A Tacoma firm that provides billing for physicians and other medical professionals in Washington and elsewhere has agreed to pay $14.5 million to settle allegations by a whistleblower that it overbilled Medicare and other federal health-care programs.
Sound Inpatient Physicians Inc. employs more than 700 clinicians and doctors to 70 hospitals and a growing number of post-acute care facilities in 22 states. A 2009 lawsuit, filed by a former employee, alleges the company routinely submitted claims that upgraded billing for its doctors.
The settlement, announced Wednesday, addresses allegations by a former employee that between 2004 and 2012, Sound Physicians submitted inflated claims on behalf of its doctors for higher and more expensive levels of service than were documented by in patient medical records.
“Fraudulently inflated billing of government health-care programs puts those programs at risk, and impacts the system’s ability to care for the neediest in our communities,” U.S. Attorney Jenny Durkan said in a statement. “During this time of tight government budgets, we will do all we can to make sure everyone plays by the rules and does not run up the taxpayers’ tab.”
Allegations that Sound Physicians had improperly billed a variety of federal health-care programs were brought to the government’s attention through a so-called “qui tam” lawsuit filed by a former Sound Physicians employee, Craig Thomas, under the whistleblower provisions of the False Claims Act.
The act allows private citizens to bring civil actions on behalf of the government and share in any recovery. Thomas will receive $2.7 million of the $14.5 million settlement for exposing Sound Physicians’ inflated claims.