David B. Fein, United States Attorney for the District of Connecticut, today announced that JAMES P. RALABATE, MD, a physician, and his professional corporation, PRIMARY CARE ASSOCIATES P.C., which is located at 2890 Main Street in Stratford, have entered into a civil settlement with the government in which they will pay $700,000 to resolve allegations that RALABATE violated the False Claims Act.
The allegations against RALABATE involve fraudulent billing to Medicare occurring over a five-year period for medical services allegedly provided at various nursing homes in Connecticut. The government alleges that RALABATE billed Medicare for high-level physician services when the services of a physician were not medically necessary. The medical records did not provide documentation necessary to meet the detailed history, examination or medical decision-making requirements necessary to justify the high level of physician care. At times, there was no medical record documenting RALABATE’s visit.
The government further alleges that RALABATE billed Medicare for services he supposedly provided to patients in nursing homes when the patients were, in fact, not present in the nursing homes. Instead, the patients had been transferred to local hospitals for treatment. Yet RALABATE billed government health care programs as if he had provided medical services in the nursing homes.
To resolve their liability under the False Claims Act, RALABATE and his professional corporation will pay $700,000 in order to reimburse the Medicare programs for conduct occurring between January 1, 2006 and August 31, 2011.
In addition, RALABATE has agreed to be subject to an Integrity Agreement with the Office of Inspector General for the U.S. Department of Health and Human Services.
“Health care providers that overcharge Medicare drain critical funds from the Medicare program and increase health care costs,” U.S. Attorney Fein stated. “The U.S. Attorney’s office is committed to vigorously pursuing physicians and other health care providers who submit fraudulent claims to federal health care programs. Providers who submit false claims to the government face serious monetary and administrative sanctions.”
Under the False Claims Act, the government can recover up to three times its actual damages, plus penalties of $5,500 to $11,000 for each false claim.
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