Chicago company to pay $1M for submitting false claims to Medicare

CHICAGO - A Chicago healthcare company and its proprietor have agreed to pay $1 million to settle a civil lawsuit with the United States stemming from allegations of submitting false claims to Medicare.

According to a consent judgment and settlement agreement filed in the U.S. District Court in Chicago, Brian J. Weinstein and Apollo Health Inc. were found to have violated the False Claims Act by submitting claims to Medicare for care plan oversight services that were not performed.

Care plan oversight services ("CPO") entail a physician supervising a patient receiving complex or multidisciplinary medical care. 

Weinstein directed Apollo’s billers to submit 12,592 claims for CPO services on behalf of 25 providers purportedly employed by Apollo, despite knowing that these providers had not rendered CPO services to Medicare patients, and such services were not documented in patients’ medical records.

As part of the settlement agreement, Weinstein and Apollo agreed to pay $1 million to the United States. The settlement resolves a civil lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act, allowing private citizens to bring lawsuits on behalf of the United States for false claims and share in any recovery. The United States intervened in the lawsuit prior to the settlement.

In a separate criminal case, Weinstein previously pleaded guilty to a federal health care fraud charge last year and received a three-year probation sentence.