The United States has intervened in a whistleblower suit filed in the U.S. District Court for the Northern District of Mississippi against Mitias Orthopaedics, PLLC. Mitias provides orthopedic care in New Albany, MS.
The suit alleges that Mitias knowingly submitted false claims for FDA-approved name-brand knee injectable devices, and received payment at those rates, but actually purchased and utilized a much cheaper product from a compound pharmacy to increase profit margin.
The lawsuit was originally filed under the qui tam or whistleblower provisions of the False Claims Act by a pharmaceutical sales representative. Under the acts, a private party, known as a relator, can file an action on behalf of the United States and receive a portion of the recovery. The act permits the United States to intervene in and take over the action, as it has done here. If a defendant is found liable for violating the act, the United States may recover three times the amount of its losses plus applicable penalties and costs.
“Our office is committed to protect taxpayer dollars from waste, fraud, and abuse and ensure the integrity of our federal healthcare programs like Medicare, Medicaid, TRICARE and Railroad Medicare,” said U.S. Attorney William C. Lamar for the Northern District of Mississippi. “CMS/Medicare is ready, willing, and able to pay for high-quality products. Any attempt to manipulate the reimbursement system drives up costs for everyone,” Lamar added.
The lawsuit is being handled by the Civil Division within the U.S. Attorney’s Office for the Northern District of Mississippi. Investigative support is being provided by the Department of Health and Human Services Office of Inspector General and Office of General Counsel, the Centers for Medicare and Medicaid Services, and the Food and Drug Administration.
The case is captioned United States ex rel. Gray v. Mitias Orthopaedics, PLLC (3:15-cv-127). The claims alleged in the lawsuit are allegations only, and there has been no determination of liability. The United States will file its own formal complaint as allowed by law.