NYC Doctor Known for Monotone Radio Spots Agrees to Medicare Fraud Whistleblower Settlement
Gilbert Lederman, the former director of radiation oncology at Staten Island University Hospital, who treated late Beatle George Harrison, has agreed to pay $2.5 million to settle Medicare fraud whistleblower allegations involving his billings, and admit to no fault.
The federal government claimed that Lederman defrauded the Medicare program by seeking reimbursement for experimental cancer treatments, which he claimed to have pioneered in the US.
The Medicare fraud whistleblower lawsuit is roughly 10 years old. A settlement in the case was finally reached on Monday, November 24th. The Medicare fraud case, filed under the False Claims Act, alleges that between 1996 and 2003, Lederman improperly sought reimbursements for 300 stereotactic body radiosurgery treatments on cancer patients. At the time, Medicare limited the coverage of those treatments to cancers above the neck, and anything else, including the treatments Lederman billed for, were considered “experimental” and therefore were be covered.
Lederman allegedly miscoded his Medicare claims in order to defraud the federal program and receive reimbursement.
Staten Island University Hospital agreed to pay $25 million related to Medicare fraud claims for the same whistleblower lawsuit in September 2008.
“Providers who misrepresent their services – whether for the purpose of obtaining greater reimbursement or in an effort to conceal the fact that a treatment was deemed investigational – continue to pose a threat to Medicare,” U.S. Attorney Loretta Lynch said in a statement.
Lederman is notorious for claims that he put his “self-interest” above patients’ interests when George Harrison’s widow sued him for shoving a guitar in the guitarist’s face after a radiation treatment and demanding Harrison sign it.
“Dr. Lederman . . . obtained millions of dollars in payments to which he was not entitled at the expense of cancer patients, as well as the public,” said an attorney for the whistleblower, Elizabeth Ryan, whose husband was treated for cancer at the Staten Island University Hospital, with Lederman overseeing treatment. Ryan filed the whistleblower lawsuit against the hospital and Lederman in 2004, and the Department of Justice joined in 2008.
Whistleblower Protections and Medicare Fraud Claims
“Qui Tam” are the first words of a Latin clause referring to the plaintiff as “one who sues as much for the state as for himself or herself.”
It is a provision of the Federal Civil False Claims Act that allows a private citizen to file a suit, in the name of the U.S. Government, charging fraud by government contractors and other entities that receive or use government funds. Bolstered by amendments passed by Congress in 1986, the law has armed private citizens who have independent and direct knowledge of fraud, whether financial institution fraud or Medicare fraud, with a weapon to prosecute government contractors and others who are defrauding the Government.
Common whistleblower actions include:
- Medicare fraud,
- defense contractor fraud, and
- other kinds of fraud against state or federal government
Qui tam lawsuits have been, and continue to be, a very effective and successful tool in combating government procurement and program fraud.
The Strom Law Firm Can Help Protect Medicare Fraud Whistleblowers with the False Claims Act
If you are personally aware of a fraud that has been committed by your current or former employer, a competitor or otherwise, from tax evasion to Medicare fraud, contact the South Carolina Qui Tam attorneys at the Strom Law Firm today for a no cost consultation to discuss the facts of your case and whether filing a qui tam may be appropriate. We understand the complexity of the False Claims Act, and can help you with your case. We offer free, confidential consultations so contact us for help today. 803.252.4800