Cleveland Clinic accused of Medicare fraud in False Claims Act lawsuit

Cleveland Clinic has been hit with a federal False Claims Act lawsuit alleging the system performs unnecessary medical tests and procedures on patients, according to a cleveland.com report.

The lawsuit, which was unsealed this week, was originally filed under the qui tam, or whistle-blower, provisions of the False Claims Act by Sam Ghoubrial, MD, an internal physician who said he witnessed many of Cleveland Clinic's alleged improper practices "firsthand through his patients, through his friends, through his family and as a referring practitioner," according to the report.

The federal government declined to intervene in this case; therefore, Dr. Ghoubrial and his attorney will prosecute the claim.

Scott Becker, JD, partner at McGuireWoods says, "When the government chooses not to intervene, it decreases the probability of success by the relator, and Cleveland Clinic likely views it as good news that the government didn't intervene in this case."

A Cleveland Clinic spokeswoman, Eileen Shell, provided a statement saying, "We are pleased that the federal government declined to pursue his claims, and we fully expect to prevail in any litigation," according to the report.

The lawsuit alleges Cleveland Clinic performs tests "that have already been done to confirm a diagnosis that has already been made for the purpose of financial gain," according to the report.

The lawsuit further alleges Cleveland Clinic exposes patients "to unnecessary radiation, unnecessary tests and unnecessary financial hardship," and both the patient and Medicare are "incurring the loss," according to the report.

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