June 5, 2022

The United States Attorney’s Office for the District of Maryland announced on March 25, 2022 that a Salisbury, Maryland medical practice, Peninsula Internal Medicine, L.L.C., and the estate of its former owner have paid the United States $286,631.33 to settle allegations that Peninsula Internal Medicine (“PIM”) and its former owner, Candy Burns, submitted false claims to the United States for medical services that were not provided. According to the settlement agreement, from January 1, 2009 to June 30, 2016, PIM and Burns billed and were paid for blood draws that were not rendered.

The blood draws were performed by LabCorp while in PIM’s Winterplace Parkway location and LabCorp was paid for these blood draws. Additionally, PIM and Burns were paid by Medicare for smoking cessation counseling that was not performed. The settlement agreement also resolved claims that PIM and Burns violated Medicare’s “incident to” rules by billing for services performed by mid-level providers on Fridays when no physician supervised or directed medical services. Medicare reimburses at a higher rate if the services provided by a mid-level provider is performed “incident to” the direction and supervision of a physician. The only physician employed at PIM did not work on Fridays. Notwithstanding that fact, Burns and PIM billed Medicare for services on Fridays as if they were supervised by a physician, thus falsely entitling them to greater reimbursement.

On June 25, 2019, Candy Burns was indicted by the United States on one count of health care fraud and nine counts of wire fraud. On or about December 5, 2019, Burns suffered a brain aneurysm and persisted in a vegetative state. The United States dismissed the indictment against Burns in April 2020. In January 2021, Burns died. The criminal case was captioned United States v. Burns, Criminal Case No. JKB 19-CR-313.

The civil settlement resolved a lawsuit filed by Kimberly Elliott, a former employee of PIM, under the whistleblower provision of the False Claims Act. The False Claims Act permits private parties to file suit on behalf of the United States for false claims and obtain a portion of the government’s recovery. The civil lawsuit is captioned United States ex rel. Kimberly Elliott v. Peninsula Internal Medicine, LLC and the Estate of Candy Burns, JKB 15-176 (D. Md). As part of the settlement, the Ms. Elliott will receive $57,326.26.

Source

If you have information regarding false claims in Maryland or elsewhere having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publicly known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in Maryland or in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

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