Whistle-blower case against American Sleep Medicine settles for $15.3M
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Jacksonville, Fla.-based American Sleep Medicine L.L.P. has agreed to pay $15.3 million to resolve U.S. Department of Justice charges for billing for sleep diagnostic services that were ineligible for payment, while a whistle-blower in the case will receive a $2.6 million award in the case, the department said Thursday.
The DOJ said American Sleep was charged with billing Medicare and Tricare — the health program for uniformed service members, retirees and their families — for claims it knew were false because they were performed by technicians who did not have the required credentials or certifications. The DOJ charged that American submitted the claims between Jan. 1, 2004, and Dec. 31, 2011.
The allegations covered by the settlement were raised in a whistle-blower lawsuit filed under provisions of the False Claims Act. Whistle-blower Daniel Parnell will receive the $2.6 million as part of the settlement, the DOJ said.
American Sleep operates 19 diagnostic sleep testing centers in 14 states. The company’s primary business is to provide testing for patients suffering from sleep disorders such as obstructive sleep apnea. Under federal program requirements for the reimbursement of claims submitted for sleep disorder testing, initial sleep studies must be conducted by technicians who are licensed or certified by a state or national credentialing body as sleep test technicians, said the DOJ.
The settlement agreement also requires enhanced accountability and wide-ranging monitoring activities conducted by internal and independent external reviews, the DOJ said.
A company spokesman could not immediately be reached for comment.
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