Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
By Eric Topor
A home health provider and its owner were hit with an almost $2 million False Claims Act judgment Oct. 20 for defrauding the District of Columbia’s Medicaid program ( United States v. Dynamic Visions, Inc. , 2017 BL 376592, D.D.C., No. 11-cv-695, 10/20/17 ).
The U.S. District Court for the District of Columbia accepted evidence from an FBI investigator that Dynamic Visions Inc. (DVI) submitted from January 2006 through June 2009 $489,744 in fraudulent Medicaid claims, which were tripled under the FCA’s damages provision. The court previously granted the Department of Justice judgment on DVI’s liability for submitting the false claims, and on the personal liability of DVI’s owner, Isaiah Bongam, for the fraudulent claims, in a December 2016 ruling on liability alone.
The DOJ has made prosecution of individuals responsible for corporate fraud an enforcement priority since the introduction of the Yates memo in 2015, and prosecutors’ efforts to hold Bongam personally liable for DVI’s actions are another example of that effort. The DOJ’s Deputy Attorney General Rod Rosenstein stated Oct. 6 that the memo’s guidelines are undergoing review, but health-care attorneys expect the DOJ’s push to hold culpable individuals accountable in corporate fraud to continue.
The government also requested the maximum allowable per-claim fine under the statute, $11,000, for the 47 false claims DVI submitted, amounting to an additional $517,000 in per-claim penalties and a total judgment of nearly $2 million against DVI and Bongam personally. Judge Colleen Kollar-Kotelly agreed with the DOJ that the forging of physician signatures on patient health plans and the commission of fraud against a program designated for needy people merited the maximum allowable per-claim fine.
Brian J. Markovitz, with Joseph Greenwald & Laake PA in Greenbelt, Md., told Bloomberg Law Oct. 23 that individuals who commit fraud “shouldn’t be able to hide from their misdeeds by claiming corporate protections.” Markovitz, who represents whistle-blowers in FCA lawsuits, said there is a stronger deterrent factor against fraud when individuals are held personally accountable.
Bongam’s attorney, Jude C. Iweanoge in Washington, told Bloomberg Law that his client planned to appeal the judgment but declined to comment further. The DOJ declined to comment on the case.
The bulk of the total judgment consisted of the tripled claim amounts, which came from an FBI investigator’s assessment of Medicaid claims that DVI made pursuant to fraudulent or missing care plans, and was supported by information supplied by the District of Columbia’s Department of Health Care Finance. Kollar-Kotelly rejected the defendant’s arguments to limit the relevant time period to December 2008, and the FCA’s damages provision, which generally mandates triple damages, left little room for alteration of that portion of the judgment.
The court had more latitude in the parties’ arguments on per-claim fines, which can vary between $5,500 and $11,000 per claim. Kollar-Kotelly noted the government’s perhaps conservative decision to label each computerized invoice submission as a “claim,” even though each electronic submission contained multiple invoices for individual care recipients, which Kollar-Kotelly said could “theoretically” be considered a claim.
Markovitz said pursuing only the submitted invoices for per-claim fines was a solid strategy. "[I]t makes sense to go for the obvious false claims, for which there can be no dispute, and then seek the highest penalties given the egregious conduct by the defendants,” Markovitz said. He added that the government’s decision on this portion of the judgment might have been influenced by the defendants’ ultimate ability to pay the judgment.
Jude C. Iweanoge in Washington represented the defendants. The U.S. Attorney’s Office for the District of Columbia represented the government.
To contact the reporter on this story: Eric Topor in Washington at email@example.com
To contact the editor responsible for this story: Peyton Sturges at firstname.lastname@example.org
The opinion is at http://src.bna.com/tBj.
Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)