Resident Prevails in Medicare Whistleblower Case

CAMDEN — A Petersburg resident prevailed in a federal whistleblower case against a physician, her former employer, who billed Medicare for over $7 million, but who was not present when procedures on patients were done.
That was against Medicare regulations since Jan. 1, 2002, ruled Judge Jerome Simandle against Dr. Christopher Lucasti.
The case, reported here Jan. 22, 2010, was brought by Silvana Landau, who was employed by Lucasti in his South Jersey Infectious Disease office in Somers Point.
According to Landau’s attorney, Joseph Martin, payments have begun being made to Landau, ($81,000), the government ($189,000) and the firm Archer and Greiner of Haddonfield, ($361,000).
The case was litigated for nearly five years, said Martin in a telephone interview.
He said Landau informed Lucasti that infusions given to patients without him being physically present was “an unlawful behavior” and that he had submitted false claims for reimbursement to the federal Medicare program.
Martin said the $7 million in billings represented 800 patient infusions over the span from 2002-2006.
He said after being told by Landau that the action was wrong, Lucasti continued the practice.
“When she left,” said Martin, “she decided to right a wrong.
“After great deliberation and discussion with me about that decision, as well as imagining serving as a federal government whistleblower, which meant she subjected herself to financial, emotional and employment risks, and she was subjected to all, she was convinced she had made the right decision,” Martin said.
Martin deemed Simandle’s “a right resolution, and in the process we got a very significant legal decision from Judge Simandle,” said Martin.
“He (the judge) said that the primary defense the doctor was raising, that he was permitted to submit claims for Medicare reimbursement when he was not present,” was wrong,” said Martin.
“That is significant in that regard, yet to be decided in a federal court, it got a lot of play,” he added.
After Simandle’s summary judgment, the case was settled.
“What is significant, at the end of the day, we secured $189,000 refund of taxpayers’ money,” said Martin, adding he believed that “in our small way” the case helped reduce the cost of healthcare for taxpayers.
Lucasti did not admit liability, and continues his practice at the Somers Point.
Of the $81,000 Landau will get from her former employer, Martin said, “For agreeing to serve as federal whistle-blower, she could have done better flipping hamburgers, $81,000 over five years. But Ms. Landau did not do this for the money, she did it for the good of the citizenry,” Martin said.
Of the $361,000 for attorney’s fees, Martin said $140,000 of that was for out of pocket expenses, while the other $220,000 was “our legal fees for eight professionals over an eight-year period.”
“We believe we did the right thing,” said Martin.
Further, he noted, “The U.S. Attorney in New Jersey and other U.S. Attorneys got a ‘first impression in law’ from the ruling. There were Medicare publications as well that carried the story,” Martin said.
Infusion therapy, around which the case rested, is given to a patient who has not responded to oral antibiotics. The procedure is done on an outpatient basis.
Contact Campbell at (609) 886-8600 Ext 28 or at: al.c@cmcherald.com