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Tampa Bay Doctor Agrees to Pay United States $1.7 Million to Resolve Medicare Fraud Allegations

Friday, September 18, 2009 General News J E 4
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WASHINGTON, July 17 Dr. Gabriel DeCandido, a physician practicing internal medicine in Largo, Fla., has agreed to pay the United States $1.7 million to settle allegations that he defrauded the Medicare program, the Department of Justice announced today.

In a complaint filed in the United States District Court for the Middle District of Florida, United States ex rel. Michael Flanery v. Dr. Gabriel DeCandido, et al., the United States alleged that Dr. DeCandido violated the False Claims Act by billing the Medicare program for higher levels of service than he actually rendered to patients and by billing for services not provided.

"Every year, billions of dollars are lost to Medicare and Medicaid fraud," said Tony West, Assistant Attorney of the Justice Department's Civil Division. "This case demonstrates our commitment to vigorously pursuing those who defraud Medicare. Taxpayer dollars should be spent on health care services for patients, not wasted on fraud and abuse."

The court found that the United States presented sufficient evidence showing that Dr. DeCandido attempted to hide and transfer his assets to avoid having to pay a judgment to the United States. To ensure that any judgment against Dr. DeCandido would be satisfied, the court permitted the government to seize five of his vehicles and garnish $976,000 that Dr. DeCandido transferred to his wife.

Today's settlement also resolves allegations made by a relator, commonly known as a "whistleblower," under the False Claims Act, which allows a qualifying relator to receive a share of the settlement proceeds. The relator's suit was filed in the United States District Court for the Middle District of Florida. The relator's share of the recovery is $306,000.

As part of today's agreement, Dr. DeCandido entered into a Corporate Integrity Agreement (CIA) with the United States Department of Health and Human Services, Office of Inspector General, requiring him to engage in significant compliance efforts over the next five years. Among other provisions, the CIA requires Dr. DeCandido to engage independent review organizations to review the accuracy of the claims that he submits to the Medicare program.

Assistant Attorney West acknowledged the contributions made by both the Commercial Litigation Branch of the Civil Division and the Office of Counsel to the Inspector General for the Department of Health and Human Services in investigating and resolving this matter.

SOURCE U.S. Department of Justice
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