American Sleep Medicine LLC (“American Sleep”) is the owner and operator of sleep diagnostic testing centers in 14 states: Alabama, Florida, Delaware, California, Illinois, Kansas, Indiana, Kentucky, Maryland, New Jersey, Missouri, Texas, Tennessee and Virginia. According to the Justice Department, American Sleep has agreed to pay $15.3 million to resolve allegations that it billed the government health care programs Medicare, TRICARE and the Railroad Retirement Medicare Program for services that were not eligible for payment in violation of the False Claims Act.
American Sleep, based in Jacksonville, Florida, provides diagnostic sleep testing to individuals suffering from sleep disorders like obstructive sleep apnea, the most common type of sleep apnea. Sleep apnea is a common disorder in which a person temporarily stops breathing while sleeping. Sleep apnea often goes undiagnosed because doctors usually can’t detect the condition during routine office visits and the condition only happens during sleep. The most common test used to diagnose sleep apnea is a procedure called polysomnographic diagnostic sleep testing. In order for the procedure to be eligible for reimbursement under Medicare and TRICARE, the initial sleep study must be performed by a technician that possesses certain credentials or certifications.
A complaint filed by whistleblower Daniel Purnell under the qui tam provisions of the False Claims Act alleged that American Sleep knowingly utilized technicians that did not have the requisite credentials or certifications to perform the diagnostic sleep testing. Purnell further alleged that American Sleep violated the False Claims Act when it submitted bills to the government seeking payment for those tests. According to the whistleblower’s complaint, the false claims were submitted from 2004 to 2011.
Of the $15,301,341 settlement amount, the whistleblower will receive $2,601,228 as his reward under the qui tam provisions of the False Claims Act.