“Companies that bill Medicare and other federal healthcare programs must ensure that they are billing for the services actually ordered by medical providers, rather than the most expensive service,” said U.S. Attorney Jacqueline C. Romero for the Eastern District of Pennsylvania. “This office will continue to pursue cases that will reduce costs for the government while ensuring that patients receive consistent and quality care, as prescribed by their physicians.”

“Proper billing of federal insurers is essential and underpins the reliability of our health care system,” said Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG, along with our law enforcement partners, will continue to steadfastly pursue entities which fraudulently charge federal health care programs for financial gain and ensure they are held accountable.”


“Today's announcement demonstrates our ongoing commitment to work with the U.S. Department of Justice and our law enforcement partners to investigate allegations of fraud against TRICARE, the healthcare system for military members and their dependents,” stated Special Agent in Charge Patrick J. Hegarty for the Northeast Field Office of the Defense Criminal Investigative Service, the law enforcement arm of the Department of Defense Office of Inspector General. “When healthcare providers submit claims to TRICARE for services that are excessive and medically unnecessary, they place financial pressure on the TRICARE system and undermine its integrity.”

“The VA Office of Inspector General is committed to safeguarding the integrity of VA’s healthcare programs and preserving taxpayer funds,” said Special Agent in Charge Christopher Algieri of the Department of Veterans Affairs (VA) Office of Inspector General’s Northeast Field Office. “We thank the DOJ Civil Fraud Section, the United States Attorneys’ Offices and our law enforcement partners for their efforts leading to today’s meaningful settlement.”

“The OPM OIG takes fraud against the Federal health care programs very seriously,” said Deputy Assistant Inspector General for Investigations Conrad J. Quarles of the Office of Personnel’s Office of Inspector General (OPM OIG). “Our office stands ready to work with our law enforcement partners on holding unscrupulous health care providers accountable.”

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Michael Pelletier, an individual employed by one of LifeWatch’s customers, and SFP I LLC, whose members are Paul Davis, Charles Richardson, MD, MBA and Chris Riedel. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam cases are captioned U.S. ex rel. Pelletier et al. v. LifeWatch Services, Inc., et al., No. 2:18-cv-11391 (D.N.J.), and United States ex rel. SFP I, LLC v. LifeWatch Corp., et al., No. 2:19-cv-2169 (E.D. Pa.). As part of today’s resolution, Pelletier will receive approximately $2.3 million, and SFP I, LLC will receive approximately $270,000.

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