Government Joins Whistleblower’s Qui Tam Lawsuit Against Hospitalist Company Alleging False Claims Act Violations

The Justice Department has joined a whistleblower’s qui tam lawsuit against IPC The Hospitalist Co., Inc. (“IPC”), and its subsidiaries, alleging violations of the federal False Claims Act. The federal False Claims Act permits the federal government to intervene in qui tam lawsuits filed by whistleblowers who allege violations of the False Claims Act.

According to its website, IPC, based in North Hollywood, California, employs over 1,400 hospitalists in 28 states. In addition, it provides inpatient care supported by IPC-Link® physician software technology. It also offers management and administrative services to medical facilities for tasks like billing, collections, recruitment, marketing, and training.

A hospitalist is a medical practitioner whose primary focus is the care of hospital patients. Typically, hospitalists do not have a private office practice. Rather, they only care for patients in the hospital setting. According to a recent survey, approximately 90% of hospitalists are trained in general internal medicine. Currently, it is estimated that there are approximately 30,000 hospitalists in the nation.

The qui tam lawsuit that was filed against IPC in the United States District Court for the Northern District of Illinois alleges that IPC submitted claims to Medicare for more expensive levels of medical treatment than was actually performed by the hospitalists. According to the whistleblower, IPC encouraged its physicians to bill Medicare for the highest level of service regardless of what level of service the physician actually gave. This practice is known as “upcoding.” The whistleblower alleges that the IPC physicians’ practice of upcoding resulted in the submission of false claims to Medicare and other taxpayer funded health care programs in violation of the federal False Claims Act.

The whistleblower, Bijan Oughatiyan, is a former IPC physician. If the matter settles or the court rules in favor of the government and the whistleblower, the whistleblower may be entitled to a percentage of any monetary recovery under the qui tam provisions of the False Claims Act. The False Claims Act provides for the recovery of three times the government’s damages, plus additional civil penalties.

To read more about how to become a whistleblower or how to bring a qui tam action, click here.