Florida Doctor Pays $750,000 to Settle Allegation of Medicare Fraud, Sheller Law Firm Represents Whistleblowers

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Whistleblower lawsuit claims Dr. Steven Chun of Sarasota Pain Associates submitted false claims to Medicare

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McCormick in Law 360 said his clients were pleased with the settlement . . . due to its provisions stopping the alleged false billing, noting Chun would be subject to the "pretty strict guidelines" of the integrity agreement.

Sheller, P.C. law firm announces that Sarasota Pain Associates, P.A. (SPA) and its owner, Dr. Steven Chun, have agreed to pay $750,000 to resolve allegations by the law firm’s whistleblower clients that SPA violated the False Claims Act by submitting Medicare claims for procedures and services that he did not perform. During the time in question, SPA operated its pain management practice in Sarasota, Florida, and then in Bradenton. 

According to the U.S. Department of Justice (DOJ) in the case U.S. ex rel. Gavin v. Sarasota Pain Associates, P.A. and Steven Y. Chun, M.D., 6:11-cv-583-T-23TBM (M.D. Fla.), the allegations of Medicare fraud were raised in a lawsuit filed by Cathia Gavin and Penelope Thomas who both formerly worked as nurses for Dr. Chun.

The whistleblower-relators were represented by attorneys Stephen A. Sheller and Brian J. McCormick, Jr. of Sheller, P.C. in Philadelphia, as well as Joseph A. Trautwein of Blue Bell, Pennsylvania, and Mary Ann Floyd, of Diez and Floyd, P.A., Englewood, Florida.  According to court documents, relators Thomas and Gavin filed a whistleblower lawsuit under seal in the United States District Court for the Middle District of Florida in 2011. 

The lawsuit alleges that Dr. Chun and Sarasota Pain Associates knowingly submitted false claims for payment for patient evaluation, management services billed at a higher level and rate, and unnecessary and unrendered procedures which were paid by Medicare and Medicaid, in violation of the False Claims Act.  Additional charges included refills of implantable infusion pumps as if performed by a physician, when they were performed by a nurse, and injections that were not given. The United States joined their lawsuit on January 17, 2014.

In the DOJ report of the settlement, Dr. Chun and SPA have agreed to enter into an Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General, which requires Dr. Chun to attend training courses provided by the Center for Medicare Services and to conduct an independent external review of his coding and billing processes.

McCormick, in an interview with LexisNexis Law 360, said his clients were pleased with the settlement, most of all due to its provisions stopping the alleged false billing, noting Chun would be subject to some "pretty strict guidelines" under his integrity agreement.

The settlement stems from the whistleblower complaint pursuant to the qui tam provisions of the False Claims Act, which permits private persons with insider knowledge of fraud, waste and abuse to bring a lawsuit on behalf of the government and to share in the proceeds of the recovered stolen funds. The Act also permits the government to intervene in the lawsuit and take over the allegations. These statutes allow governments to recover three times the amount they were defrauded, in addition to civil penalties of $5,500 to $11,000 per false claim. Successful whistleblowers can receive between 15 and 30 percent of the governments’ recovery.

The DOJ says the settlement was achieved through the coordinated efforts of a team of attorneys from the U.S. Department of Justice and the U.S. Attorney’s Office for the Middle District of Florida. The team was led by Randy Harwell, Chief of the Civil Division and Assistant U.S. Attorney Kathy Ho, both  the U.S. Attorney’s Office from the Middle District of Florida. 

In the interview with Law 360, McCormick praised the attorneys and investigators in the case, saying they had done a “superb” job, giving Chun little choice but to settle the case. "The U.S. Attorney’s Office in Tampa did a fantastic job,” said McCormick. “Randy Harwell, Kathy Ho and Special Agent Ian Ives of the Office of Inspector General for HHS should be commended for their tireless work on this case.”

About Sheller, P.C.

Sheller, P.C. represents plaintiffs injured by defective drugs, devices, and consumer products nationwide as well as whistleblowers reporting corporate and government fraud. In practice since 1977, Sheller, P.C. has challenged some of the largest corporations in the United States, including pharmaceutical and medical device companies, auto, tobacco and others. The firm also represents whistleblowers in federal and state False Claims Act matters, including pharmaceutical qui tam matters that have recovered more than $6.2 billion for the U.S. Government to date, including some of the largest in U.S. history.(1,2,3,4,5)

(1) United States ex. rel. Victoria Starr, et al. v. Janssen Pharmaceutica Prods., L.P., No. 04-1529
(2) United States ex. rel. Robert Rudolph, et al. v. Eli Lilly and Company, No. 03-943
(3) United States ex. rel. Ronald Rainero, et al. v. Pfizer, Inc., No. 07-11728
(4) United States ex. rel. James Wetta, et al. v. AstraZeneca Corp., No. 04-0379 
(5) Price v. Philip Morris USA, 848 N.E.2d 1 (Ill. 2005)

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Brian J. McCormick, Jr., Esq.

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