Prevea Clinic Inc. Agrees to Civil Settlement of $94,000 to Resolve False Claims Act Allegations

United States Attorney James L. Santelle for the Eastern District of Wisconsin announced today that the United States has reached a civil settlement with the Prevea Clinic Inc., resolving allegations that Prevea submitted false claims to the Medicare Program. The amount of the settlement is $94,000.

Prevea provides health care services in northeastern Wisconsin through a group of clinics that employ physicians and other health care providers. The civil settlement resolves a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens with knowledge of fraud to bring a civil action on behalf the United States and to share in any recovery. As part of the resolution, the whistleblowers will receive a share of the settlement.

The qui tam complaint alleges that Prevea submitted false claims to the Medicare Program for the services of an assistant surgeon during neurosurgery procedures between January 1, 2005 to November 20, 2010. The services of an assistant surgeon will be paid for by Medicare if the assistant surgeon has certain, specified credentials. It was alleged Prevea submitted claims for assistant surgeon services by an employee that did not have the credentials required by Medicare and submitted the claims for those services using another individual’s provider number and credentials. Prevea denied the allegations.

This case was investigated by special agents from the Federal Bureau of Investigation and prosecuted by Deputy Civil Division Chief Stacy Gerber Ward.