David Haron announced the settlement of a Federal False Claims Act/Qui Tam suit filed in 1996 against the Detroit Medical Center, Harper Hospital and Dr. C.B. Dhabuwala. Haron represented George Karadsheh, one of two Relators (Plaintiffs) filing suits. As a result of the Qui Tam suits, the United States government entered into a Settlement Agreement, in which the Defendants agreed to pay $361,831 to the government.
The Relators collectively received $61,851 as their share of the government's recovery and an additional $45,000 (paid by Defendants) for expenses, statutory attorneys fees and costs.
The United States alleged that: From January 1, 1988 through December 31, 1992, Defendants improperly presented or caused Harper to present claims to the Medicare and Medicaid programs for nocturnal penile tumescence ("NPT") tests that had been performed at Harper's Sleep Laboratory (currently known as the "Sleep Disorders Center"). During the relevant time frame, both the Medicare and Medicaid programs had established reimbursement guidelines for NPT tests performed by participating providers. Such guidelines indicated that providers could not bill either Medicare or Medicaid separately for NPT tests because reimbursement for NPT tests was considered to be included in the reimbursement paid to providers for office visits related to such tests. Notwithstanding these guidelines, whenever a Medicare or Medicaid patient at the Harper Sleep Disorders Centers received an NPT test, Harper routinely submitted claims to the Medicare or Medicaid program for an office visit, plus a claim for the NPT test and/or numerous additional tests which were components of the NPT test (i.e., electromyogram, electrocardiogram, electro-oculogram, etc.). This practice violated Medicare and Medicaid program rules because the component tests were not separately ordered by a physician or medically necessary for the treatment of illness or injury.
Defendants settled the suits but did not admit any liability to the government.
The United States prosecuted the action through Saul A. Green, United States Attorney in Detroit, Michigan and Carolyn Bell Harbin, Assistant United States Attorney.