A Medical Device Daily

Gabriel DeCandido, MD, a physician practicing internal medicine in Largo, Florida, has agreed to pay the U.S. $1.7 million to settle allegations that he defrauded the Medicare program, the Department of Justice reported.

In a complaint filed in the U.S. District Court for the Middle District of Florida, United States ex rel. Michael Flanery v. Dr. Gabriel DeCandido, et al., the U.S. alleged that DeCandido violated the False Claims Act by billing the Medicare program for higher levels of service than he actually rendered to patients and by billing for services not provided.

"Every year, billions of dollars are lost to Medicare and Medicaid fraud," said Tony West, Assistant Attorney of the Justice Department's Civil Division. "This case demonstrates our commitment to vigorously pursuing those who defraud Medicare. Taxpayer dollars should be spent on healthcare services for patients, not wasted on fraud and abuse."

The court found that the U.S. presented sufficient evidence showing that DeCandido attempted to hide and transfer his assets to avoid having to pay a judgment to the U.S. To ensure that any judgment against DeCandido would be satisfied, the court permitted the government to seize five of his vehicles and garnish $976,000 that he transferred to his wife.

Today's settlement also resolves allegations made by a relator, commonly known as a "whistleblower," under the False Claims Act. The relator's suit was filed in the U.S. District Court for the Middle District of Florida. The relator's share of the recovery is $306,000.

As part of today's agreement, DeCandido entered into a Corporate Integrity Agreement (CIA) with the U.S. Department of Health and Human Services, Office of Inspector General, requiring him to engage in significant compliance efforts over the next five years. Among other provisions, the CIA requires DeCandido to engage independent review organizations to review the accuracy of the claims that he submits to the Medicare program.