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Two Tennessee and Virginia orthopedic clinics have agreed to pay a combined $1.85 million dollars to settle allegations of billing Medicare Fraud for reimported products in violation of Federal law and the Tennessee False Claims Act.  The osteoarthritis known as viscosupplements were purchased by Tennessee Orthopedic Clinics, P.C., headquartered in Knoxville, Tennessee, and Appalachian Orthopedic Clinics, P.C., headquartered in Kingsport, Tennessee.   As noted by Assistant Attorney General for the Justice Department Stewart F. Delery, “the Department of Justice will not tolerate the conduct of companies that impermissibly shift risks on to patients in order to increase their own profits.”

The viscosupplements, including synvisc and orthovisc are injections approved by the Food and Drug Administration for the treatment of osteoarthritis pain in the knee.  The government contended in a False Claims Act case filed that the clinics knowingly purchased deeply discounted viscosupplements that were reimported from foreign countries and billed viscosupplements to State and Federal healthcare companies in order to profit from the reimbursement system, when such reimported viscosupplements were not reimbursable by those programs.  Allegedly, the reimported products included labeling in foreign languages and in English for additional uses not approved in the United States, which demonstrated that the products were reimported.

Furthermore, because the product was reimported the government alleged there was no manufacturer assurance that it had not been tampered with or that it was stored appropriately. The allegations resolved by the settlement were first raised in a lawsuit filed against the two healthcare clinics under the qui tam or whistleblower provisions of the False Claims Act by Douglas Estey, a physician’s assistant who was occasionally paid by Gensym Corp. to speak to medical providers about the use of synvisc.  Estey, who was not employed by either clinic, will receive $320,750.00.   One of the areas in which our firm tries to help persons stop fraud against the government is for fraudulent medical billing by healthcare companies, including medical providers such as the ones that settled this case with the government.

The False Claims Act prohibits companies from knowingly making false claims against the government at the expense of taxpayers.  In this case, the two healthcare clinics knowingly sold products that were not eligible for reimbursement and profited at the expense of honest taxpayers across the country.  Our firm applauds the whistleblower for coming forward and speaking out against fraud, and stands ready to discuss any fraudulent conduct that you are aware of as it relates to businesses in the country

If you have confidential information about a fraud against the government in Tennessee, Kentucky, Mississippi, Alabama, Arkansas or another state, please contact us as soon as possible for a free case evaluation.

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We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today, or visit our False Claims Act Litigation Source.

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Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.