Jitesh Patel, M.D., Advanced Urology, Inc., and affiliated companies will pay $14 million to settle allegations that they violated the False Claims Act and the Georgia False Medicaid Claims Act by billing federal healthcare programs for procedures that were either not performed or medically unnecessary, according to an April 2 announcement from authorities.
The settlement addresses concerns about fraudulent billing practices in healthcare, which can divert resources away from patients who need them. Federal officials say such actions undermine the integrity of government health programs like Medicare and Medicaid.
“Physicians commit fraud when they seek payment for medically unnecessary procedures or bill for services they never performed,” said U.S. Attorney Theodore S. Hertzberg. “Our office will not tolerate abuse of patients or misuse of government funds, and we will enforce the False Claims Act to hold wrongdoers accountable.” Kelly Blackmon of the Department of Health and Human Services Office of Inspector General said, “Today’s action underscores our commitment to safeguarding federal health care programs from fraud and abuse.” Peter Ellis with FBI Georgia stated, “This settlement underscores the FBI’s commitment to investigating complex healthcare fraud schemes that prioritize profit over patient care.” David Spilker with the VA Office of Inspector General added, “This settlement demonstrates the VA OIG’s tireless commitment to protecting veterans’ healthcare programs from fraudulent billing.” Jim Mooney from Georgia’s Medicaid Fraud Division said, “Fraud against the Medicaid program is stealing from Georgia taxpayers – plain and simple.” Jason Sargenski with Defense Criminal Investigative Service remarked, “This settlement should serve as a strong deterrent to healthcare practitioners who abandon their Hippocratic Oath while seeking to exploit and defraud TRICARE…”
The investigation began after two whistleblowers—one a former employee and another a former physician at Advanced Urology—filed complaints alleging unnecessary medical procedures were being performed or billed without being done at all. The alleged practices included implanting devices without proper evaluation, performing rarely used tests on nearly every new patient, ordering thousands of unneeded ultrasounds, and billing for more complex procedures than those actually conducted.
According to the official website, the U.S. Attorney for the Northern District of Georgia prioritized prosecution of threats such as terrorism, human trafficking and civil rights violations while serving a region covering 7.5 million residents across north Georgia mountains through Atlanta suburbs into bordering states. The office enforced federal criminal laws as well as represented civil matters on behalf of the United States while coordinating cases with national or international impact.
Theodore S. Hertzberg held his position as United States Attorney for this district according to official sources. The agency also served as principal federal law enforcement authority in its jurisdiction according to its website.
Under terms outlined in court filings related to this matter—including two lawsuits filed under whistleblower provisions—the Relators will receive nearly $3 million collectively from this civil recovery. Authorities noted that these claims are allegations only; there has been no determination of liability.
