In this issue:

• Court dismissed relator's claims against hospital for allegedly fraudulent sleep tests where relator lacked personal knowledge of specific false claims, but permitted claims based on relator's own firsthand work in the Sleep Lab to go forward.
• Prime contractor found liable and subject to civil penalties under the Anti-Kickback Act's strict liability provision for subcontractor's acceptance of bribes, even without evidence of prime contractor's knowledge of kickback scheme.

United States ex rel. Revels v. Putnam Cmty. Med. Ctr. of N. Fla., No. 3:19-cv-00834-TJC-LLL, 2022 WL 14834500 (M.D. Fla. Oct. 26, 2022)

Industry: Healthcare

Topics: Medically Unnecessary Services

Summary: Last week, the District Court for the Middle District of Florida denied in part Putnam Community Medical Center's (PCMC) motion to dismiss relator Willard Revels' Second Amended Complaint and motion to strike paragraphs of the Second Amended Complaint.

Relator, a former employee of PCMC, alleged PCMC defrauded government-funded healthcare programs when it administered sleep and cardiopulmonary tests. The applicable regulation (42 C.F.R. § 410.32) requires a physician's presence or a physician's comprehensive training and supervision program for diagnostic tests to be "reasonable and necessary" for a given patient, and thus payable by government insurance. Relator alleged that the CEOs, compliance officers, and directors of cardiopulmonary services knew that the training and...

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