Last week one of the first qui tam suits alleging manipulation of the billing rules for a type of remote patient monitoring was unsealed, following the relator’s voluntary dismissal. See United States ex rel. Mathurin v. Vector Remote Care LLC (Nov. 18, 2020 E.D.N.Y.). Relators not infrequently voluntarily dismiss their case when DOJ informs them that it lacks merit. Whatever the merits of this one, given the explosive increase in remote patient monitoring during the pandemic and the predicted future increases in these patient care modalities, we expect continued whistleblower activity focused on this space. Of course, such allegations will be met with substantial challenges to establishing that these kinds of issues in fact fail to comply with the applicable coverage and reimbursement criteria or render any claims materially false.
In this case the relator, a former employee of the defendant who filed a qui tam suit approximately a month after her employment was terminated, alleges that her former employer submitted false claims for remote cardiac monitoring. In particular, she claims that the company, which provides the technical component of remote cardiac monitoring services, “conjured a sham location in Long Island City, New York even though its true base of operations is in Oregon,” in order to be able to enroll in Medicare as a New York-based Independent Diagnostic Testing Facility. According to the relator, the defendant falsely identified New York as its practice location in order to take advantage of relatively higher Medicare rates in the New York geographic area, as compared to Oregon. Thus, the relator alleged that by claiming the remote cardiac monitoring services were performed in New York, when they were actually performed by technicians working remotely outside of New York, the defendant submitted false claims to Medicare.
A copy of the complaint is available here.