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Duke Health Settles NC Whistleblower Case

By Martin & Jones on April 18, 2014

Duke University Health System, Inc. has agreed to pay $1 million to resolve allegations under the United States and North Carolina False Claims Acts that it made false claims in conjunction with medical care provided to beneficiaries of federal healthcare programs (Medicare, Medicaid, and TRICARE). The whistleblower lawsuit was filed in the United States District Court for the Eastern District of North Carolina. The complaint alleged that Duke Health System made false claims to Medicare, Medicaid, and TRICARE by (i) billing the government for services provided by physician assistants during coronary artery bypass surgeries when the physician assistants were acting as surgical assistants, which is not permitted under pertinent government regulations; and (ii) increasing billing by unbundling claims when the unbundling was not appropriate, specifically in connection with cardiac and anesthesia services.

The allegations resolved by the settlement arose from a whistleblower lawsuit brought under the False Claims Act by Leslie Johnson, a former employee of Duke Health System. The government’s investigation was led by an Assistant U.S. Attorney in the Eastern District of North Carolina, working in conjunction with a North Carolina Assistant Attorney General.

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