Justice Department Reaches Settlement Agreement with Physicians and El Paso Physicians Group over Allegations of Violating the False Claims Act

U.S. Attorney John F. Bash of the Western District of Texas announced today that Dr. Robert Moreno, Cheryl Moreno, William “Bill” Collins, Accutrack Medical Claims Service, LLC, and El Paso Integrated Physicians Group, P.A. paid $2,929,162 to settle allegations that they defrauded the U.S. and the State of Texas through their Medicare, Medicaid and other federal healthcare programs.

“Providers who line their pockets by over-billing for medical care increase medical costs for all of us and drain critical funds from Medicare and other government health programs,” said U.S. Attorney Bash.  “The Government will continue to hold accountable medical professionals who undermine our healthcare system through fraudulent over-billing for care.”

On October 30, 2013, Sergio Garcia filed a qui tam action in the U.S. District Court for the Western District of Texas, alleging that Dr. Robert Moreno, Cheryl Moreno, William “Bill” Collins, Accutrack Medical Claims Service, LLC, and El Paso Integrated Physicians Group, P.A. double-billed and over-billed government payors for Remicade (Infiximab), an infusion drug sold in single-use vials. Relator alleged that the Group pooled Remicade from partially used vials and used it in other patients, resulting in double-billing for the split vial, and also that it billed for Remicade not used or that was diluted. The complaint further alleged that the Group billed for drugs illegally imported from Canada and other foreign countries.

Multiple federal and state agencies, including the FBI, U.S. Health and Human Services-Office of Inspector General, Department of Defense-Defense Health Agency and the Texas Medicaid Fraud Control Unit, conducted an extensive investigation into the allegations.  Based on the results of the investigation, the U.S., along with the State of Texas, pursued efforts to recover some of the federal and state funds that they allege, were illegally obtained by the defendants.

The lawsuit, United States ex rel., Sergio Garcia, v. Robert Moreno, M.D., et al., Civ. A. No. SA:13-CA-0992XR was filed under the qui tam or whistleblower provisions of the False Claims Act, which permits private parties to sue for false claims against the U.S. and to receive a share of any recovery.  The Act permits the U.S. to intervene in such lawsuits, as the U.S. has done in this case.

The claims asserted against the defendants are allegations only; there has been no determination of liability.

Department of Justice Attorney Susan Strawn (formerly an Assistant U.S. Attorney in the Western District of Texas) and Assistant U.S. Attorney Eduardo R. Castillo represented the federal government in the civil lawsuit.