United States ex rel. Lyon v. Accelecare Wound Centers, Inc., No. 12 CV 7624 (LAK) (S.D.N.Y.): Last October, Jennifer Lyon, Director of Hyperbaric Medicine at St. John’s Riverside Hospital filed a lawsuit under seal alleging that St. John’s Riverside Hospital, Accelecare Wound Centers Inc., individual physicians, and other hospitals violated the federal and New York FCAs by submitting to Medicare and Medicaid claims for services that were not conducted under the direct supervision of a physician. Accelecare partners with hospitals to provide out-patient wound care services, including a procedure known as Hyperbaric Oxygen Therapy. The therapy delivers high levels of oxygen to wounded patients, allowing damaged tissue oxygen levels to rise so as to enhance healing. Lyon alleged that non-supervising physicians were simply “signing off for billing purposes” on therapies not supervised by any physician. Four pages of the complaint contain allegations of specific instances when the physician defendants submitted such claims for reimbursement to Medicare and Medicaid. According to the complaint, when Lyon complained about this practice to a vice president of defendant St. John’s Riverside Hospital, and asked whether the hospital would report the fraud, she was told, following an expletive immediate response, “let them come for us.”
Although the court ordered the lawsuit unsealed at the end of July, a docket reference indicates a document was filed under seal on August 2, 2013, and on August 9, 2013, Lyon voluntarily dismissed the lawsuit without prejudice. It is unclear whether the parties entered into a confidential settlement. We will continue to monitor this action and report further if Lyon files a new complaint.