Anesthesiologist John Mamalakis, MD, brought a False Claims Act case against Knoxville, Tenn.-based TeamHealth, the anesthesiology group contracted at Racine, Wis.-based Ascension All Saints Hospital, The Journal Times reports.
Here are five insights:
1. Dr. Mamalakis alleges TeamHealth fraudulently overbilled Medicare and Medicaid from 2011 to at least 2014 and fired him for refusing to participate in the scheme.
2. The anesthesiologist's complaint describes rampant falsification of records. He claims there were numerous instances where TeamHealth physicians billed as if they were in operating rooms when they were actually not present.
3. The case was filed in 2014. In May, Dr. Mamalakis' lawyers filed a motion opposing TeamHealth's motion to dismiss the case. In June, TeamHealth's attorneys replied with further support of the motion to dismiss.
The U.S. Department of Justice looked into the allegations and decided not to take the case, but cleared Dr. Mamalakis and his lawyers to proceed.
4. TeamHealth told The Journal Times it investigates all compliance-related inquiries and "has a robust and long-standing compliance and ethics program." A Glendale-based Ascension Wisconsin spokesperson said in a statement, "We take compliance and patient care issues seriously. This lawsuit is between TeamHealth and one of their former employees. Therefore, we cannot comment further."
Editor's note: An earlier version of this story incorrectly stated where Dr. Mamalakis now works. Dr. Mamalakis does not work at ProHealth Waukesha Memorial Hospital.