NJ Pathology Practice to Pay $2.4 Million to Resolve False Claims Act Violation Allegations

Princeton Pathology Services P.A., a New Jersey pathology practice, reached a Settlement Agreement with the U.S. Department of Justice (DOJ) and agreed to pay the U.S. government $2.4 million to resolve allegations that it violated the False Claims Act, announced Acting U.S. Attorney Rachael A. Honig on Dec. 7, 2021.

The civil settlement resolves allegations that arose from a lawsuit filed under the whistleblower provisions of the False Claims Act. The whistleblower will receive $456,000 as a part of the federal share of the settlement.

Medicare whistleblower lawyers at Khurana Law Firm, P.C. support reporting fraud and abuse in the healthcare industry and offer help building a strong case that can result in the whistleblower receiving a reward for aiding the government in fighting fraud.

What Alleged Violations did Princeton Pathology Commit?

According to the DOJ’s contentions in the settlement agreement, Princeton Pathology allegedly made false representations in connection with submissions to the Centers for Medicare & Medicaid Services (CMS) under Current Procedural Terminology (CPT) between Jan. 1, 2015, and Dec. 31, 2020.

Princeton Pathology failed to provide written support in medical records despite the CPT code requiring written analysis by a pathologist. As a result, Princeton Pathology billed Medicare for analysis of tests while no such analyses were required or done, causing Medicare to significantly overpay.

“Submitting claims for unsubstantiated services threatens the integrity of the Medicare program and will not be tolerated,” said Scott J. Lampert, HHS-OIG Special Agent in Charge. “We will continue to protect patients and taxpayers by holding accountable providers who endanger the integrity of federal health care programs and the beneficiaries they serve.”

What was the Whistleblower’s Role in the Princeton Pathology Case?

The case was initiated by a qui tam complaint filed under the False Claims Act, which permits private parties to sue for false claims on behalf of the United States and to share in any recovery.

The whistleblower Jayant Barai, M.D. who is an internal medicine specialist from Orange, NJ, will receive $456,000 of the settlement amount for providing information that led to the case.

The DOJ’s pursuit of the Princeton Pathology lawsuit illustrates the government’s efforts to combat healthcare fraud and Dr. Barai’s assistance played a crucial role in building a strong case thus helping to defraud federal healthcare programs.

How Can Whistleblowers Help Fight Fraud in the Healthcare System?

Health care fraud has been causing tens of billions of dollars in losses each year and threatening the integrity of the Medicare program underlined DOJ representatives and encouraged persons with non-public information regarding medical system violations to report the abuse.

Medicare whistleblower lawyers at Khurana Law Firm, P.C., support the decision to come forward to report abuse and fraud in the healthcare industry. If you have become aware of a fraud or abuse scheme, you may be able to act as a whistleblower.

The national whistleblower attorney Arvind Bob Khurana helps whistleblowers build a strong case and receive a reward for aiding the government in fighting fraud. Contact us today for a consultation. For a free, confidential evaluation call (888) 335-5107