American Family Care, based in Birmingham, has agreed to pay the federal government $1.2 million to settle charges it was knowingly billing too much, according to recently unsealed records and information in a Department of Justice news release.
The civil settlement resolves a lawsuit filed by Anita C. Salters, a former employee of American Family Care, under the whistleblower provision of the False Claims Act, which permits private parties to file suit on behalf of the government for false claims and to obtain a portion of the government’s recovery.
Hare Wynn’s Don McKenna, who represented Ms. Salter, says, “She filed suit under the false claims act and the government intervened as to the up coding claims. She was in charge of billing and coding when she observed what was being done. She attempted to bring it to a halt and was terminated.”
“Mischarging the government for office visits wastes valuable government resources that could be used to care for other patient needs,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery. “At a time of increasing concern about the cost of medical care, it is especially important to ensure that health care providers are not overbilling the government by improperly inflating their claims.”
“The False Claims Act is a critical tool for weeding out fraud and protecting the taxpayers,” said U.S. Attorney for the Northern District of Alabama Joyce White Vance. “My office will continue to return funds, like the $1.2 million in this case, to the taxpayers by proceeding against those who abuse our public health programs.”
American Family Care is a network of walk-in medical clinics headquartered in Birmingham, Ala., with offices in Alabama, Tennessee and Georgia.
Don McKenna advises patients to learn more about coding and billing for medical services utilizing the Family Practice Notebook.
“If the code recorded by the medical facility doesn’t correspond with your recollection of your visit, you should contact your insurer,” states McKenna.
Hare Wynn attorney’s Don McKenna and Scott Powell will continue to represent Ms. Salters in her wrongful termination suit under the False Claims Act and in pursuing additional false claims allegations against AFC.