ATLANTA—The United States Attorney’s Office announced today that it has reached a settlement with ROBERT M. RITCHEA, M.D., 49, of Phenix City, Alabama, to resolve allegations under the False Claims Act that RITCHEA submitted more than $2.2 million in false or fraudulent claims to Medicare. Pursuant to the settlement, RITCHEA will be excluded from payment from all federal health care programs for a period of seven years. The payment prohibition applies to RITCHEA, anyone who employs or contracts with him, and any hospital or other provider for which he provides services. RITCHEA will also pay the United States the proceeds from the sale of a second home and $5,000 immediately. In the settlement process, a defendant’s ability to pay is taken into consideration when determining the settlement amount.
Sally Quillian Yates, United States Attorney for the Northern District of Georgia, said, “Our office is committed to pursuing doctors who put money before the health and safety of their patients. Dr. Ritchea admitted to allowing an unlicensed medical assistant to inject patients with pain medications and billing Medicare for these injections. As a result he will be excluded from all federal health care programs for seven years.”
The civil settlement resolves a complaint filed by the United States against RITCHEA, United States v. Robert M. Ritchea, M.D., 1:10-cv-02410-JOF. The complaint alleges that RITCHEA violated the False Claims Act by improperly billing Medicare for unnecessary pain injections administered by an unlicensed medical assistant. As a condition of the settlement, RITCHEA admitted that he allowed the unlicensed medical assistant to administer at least 80% of the pain injections. He also admitted to both the Alabama State Board of Medical Examiners and the Georgia Composite State Board of Medical Examiners that the injections were unnecessary.
The United States’ settlement is part of the government’s emphasis on combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department used to recover approximately $2.4 billion nationwide in fiscal year 2011 in cases involving fraud against federal health care programs. The Justice Department’s total health care fraud recoveries under the False Claims Act since January 2009 have been over $6.6 billion.
This settlement also highlights another powerful tool to protect federal health care programs and beneficiaries and to hold accountable those that commit health care fraud—the exclusion authority of the United States Department of Health and Human Services Office of Inspector General (HHS-OIG). Section 1128 of the Social Security Act gives HHS-OIG the authority to exclude individuals and entities from participation in federal health care programs for fraud or other misconduct.
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