Emory University to Pay $1.5 Million to Settle False Claims Act Investigation
University Overbilled Medicare and Medicaid for Patients Enrolled in Clinical Trial Research at Emory’s Winship Cancer Institute
|U.S. Attorney’s Office August 28, 2013|
ATLANTA—The United States Attorney’s Office for the Northern District of Georgia and Attorney General Sam Olens announced today they have reached a settlement with Emory University, which agreed to pay $1.5 million to settle claims that it violated the False Claims Act by billing Medicare and Medicaid for clinical trial services that were not permitted by the Medicare and Medicaid rules.
Providers generally are not permitted to bill Medicare for medical care and services for which the clinical trial sponsor has agreed to pay. Here, the United States and the state of Georgia alleged that Emory University billed Medicare and Medicaid for services the clinical trial sponsor agreed to pay (and, in some cases, actually did pay, thereby resulting in Emory’s being paid twice for the same service).
“This settlement demonstrates our office’s continued commitment to protect crucial Medicare and Medicaid dollars,” said United States Attorney Sally Quillian Yates. “Treatment of cancer is expensive, and Medicare and Medicaid dollars should be reserved for patients who need services that properly may be billed to these programs.”
“Our investigation of Emory University revealed the institution’s clinical trial false billing and led to today’s settlement,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General for the Atlanta region. “Protecting Medicare—and taxpayer dollars—remains a top priority.”
Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office, stated, “Federal funds, to include those of Medicare and Medicaid, are limited and are to be used as intended. The FBI will continue to play a role in enforcing federal law that governs the use of these much needed funds.”
Attorney General Sam Olens stated, “Cancer research is paramount to saving and extending lives. However, strict rules govern the use of Georgia Medicaid dollars. My office takes seriously its obligation to ensure that these resources are used properly.”
This civil settlement resolves a lawsuit filed by Elizabeth Elliot under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens to bring civil actions on behalf of the United States and share in any recovery obtained. The case, pending in the Northern District of Georgia, is filed under United States of America and State of Georgia ex rel. Elizabeth Elliott v. Emory University, et al., Civ. No. 1:09-cv-3569-AT (Northern District of Georgia, December 18, 2009). Ms. Elliot will receive a share of the settlement payment that resolves the qui tam suit that she filed. The claims settled in the civil settlement are allegations only, and there has been no determination of liability.
This case was investigated by the United States Attorney’s Office for the Northern District of Georgia; the U.S. Department of Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; and the Georgia Medicaid Fraud Control Unit.
The civil settlement was reached by Assistant United States Attorney Darcy F. Coty.
For further information please contact the U.S. Attorney’s Public Affairs Office at USAGAN.Pressefirstname.lastname@example.org or (404) 581-6016. The Internet address for the U.S. Attorney’s Office for the Northern District of Georgia is www.justice.gov/usao/gan.