ORLANDO, Fla. – The federal government has recouped $1.7 million from a healthcare provider who fraudulently billed Medicare and TRICARE for medical procedures that were not deemed necessary and were performed by an unqualified technician.

In the settlement agreement, Jena Medical Group LLC, as well as several individuals associated with the company, have agreed to repay federal payments to resolve allegations that they violated the False Claims Act by submitting the claims for radiofrequency ablations.

The case began with a whistleblower action brought by a former employee of the company. The whistleblower was represented by RPWB attorneys Chris Tuck, Bobby Wood and Chuck Dukes.  The investigation revealed that the company billed Medicare and TRICARE for radiofrequency ablations that were not medically necessary and were performed by an unqualified technician from January 2018 to December 2020.  Jena Medical also permitted the washing and re-use of catheters that were designed for a single use, thus putting the patients at unnecessary risk.

By law, people with information about fraudulent claims submitted to the government for payment can sue under qui tam, or whistleblower, provisions of the False Claims Act. The act allows such whistleblowers to share in the government’s recovery.

“The False Claims Act gives an additional incentive for people to report fraud perpetrated against taxpayers,” said RPWB attorney Chris Tuck. “In this case, the relator was able to help the federal government recoup a significant amount of money and share in the proceeds. We urge anyone with first-hand knowledge of fraud perpetrated against the federal government to consult with an attorney at RPWB for a confidential case review.”