San Antonio's Gonzaba Medical Group is named in a federal lawsuit brought by an Iowa nurse who alleges it falsified the severity of patients' medical conditions to boost the amount of Medicare payments it would receive.
Gayle Traver brought the suit, which also names San Antonio's WellMed Medical Management Inc. and parent company UnitedHealth Group Inc. as defendants, on behalf of the federal government under the False Claims Act in 2018. The complaint was filed under seal and didn't become public until earlier this year when the federal government declined to intervene in the case.
The companies recently filed motions to dismiss the case.
Traver worked as a temporary contract employee for Gonzaba for three months in 2017. She says she terminated the contract early over "concerns regarding fraud" in the group's Medicare billing practices.
The False Claims Act is a law intended to combat fraud against the U.S. government. Such complaints are often referred to as "qui tam" or "whistleblower" lawsuits. If a case is successful, a plaintiff can receive as much as 30% of the government's recovery.
Traver amended her lawsuit for the third time last month.
The other defendants in the case are Gonzaba Medical's founder and CEO Dr. William Gonzaba and medical director Dr. David Padilla, and Indiana-based Wellpoint Texas Inc. They each also filed motions to dismiss the case.
In its filing, Gonzaba Medical said Traver "makes her claims without detailed … allegations of any actual...
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