Criminal Investigative Updates

A Georgia-based doctor, Jitesh Patel, M.D., and his practice, Advanced Urology, Inc., and affiliated companies collectively known as Advanced Urology, will pay $14 million to settle allegations that they violated the False Claims Act by billing federal healthcare programs, including Medicare and Medicaid, for a series of urological and diagnostic procedures that were either not performed or were medically unnecessary. The government’s investigation began after a former Advanced Urology employee filed a whistleblower complaint alleging that the company performed unnecessary procedures. A second complaint was filed by a former Advanced Urology physician alleging that the practice billed government healthcare programs for procedures and tests that were not performed or unnecessary. The VA OIG, Health and Human Services OIG, Medicaid Fraud and Patient Protection Division of the Georgia Attorney General’s Office, the Defense Health Agency, and FBI investigated this case.

Wellington Brown, of New Orleans, Louisiana, was charged with providing a materially false statement to the Small Business Administration in an application to obtain a government-sponsored loan designed to assist small business owners during the COVID-19 pandemic. The VA OIG investigated this case.

Oasis Acupuncture LLC, of Orlando, Florida, and its owner, Dr. Hui-Li Yuan, have agreed to pay $100,000 to resolve allegations that they violated the False Claims Act by submitting inflated claims for acupuncture services to the Department of Veterans Affairs. According to the settlement agreement, Oasis Acupuncture and Dr. Yuan billed the VA for inflated acupuncture needle reinsertion services that did not meet the minimum 15-minute time requirement per needle reinsertion. This resulted in the VA overpaying for Oasis Acupuncture’s claims. The VA OIG investigated this case.

John H. Windom, who previously served as the executive director of VA’s Office of Electronic Health Record Modernization, was charged with failing to disclose his receipt of thousands of dollars in cash and other gifts from contractors. According to the indictment, while overseeing the $16 billion acquisition and development of VA’s Electronic Health Records solutions, Windom concealed that he was accepting, and sometimes demanding, extravagant gifts from contractors and subcontractors who worked on the project. The VA OIG and the FBI investigated this case.

Team Rehabilitation Services, LLC (Team Rehab), which operates approximately 140 physical therapy clinics in Michigan, Illinois, Indiana, Wisconsin, and Georgia, has agreed to pay nearly $5 million to settle allegations that it violated the False Claims Act by submitting false claims for payment for physical therapy services to several federal healthcare programs. The settlement resolves allegations that, from 2018 to 2024, Team Rehab knowingly and improperly submitted false claims to Medicare, Medicaid, TRICARE, the Federal Employees Health Benefits Program (FEHBP), and the United States Department of Veterans Affairs for time-based Current Procedural Terminology (CPT) codes for one-to-one physical therapy services even though those services occurred in a group setting where the provider did not maintain sufficient direct patient contact throughout the service to bill for those time-based CPT codes appropriately. The VA OIG, the Health and Human Services OIG, the Defense Criminal Investigative Service, and the Michigan Attorney General's Health Care Fraud Division investigated this case.