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Suit alleges Mayo Clinic made false Medicare claims

By Robbie Hargett | Dec 2, 2015

JACKSONVILLE, Fla. (Legal Newsline) – A woman is suing the Mayo Clinic and two of its doctors over alleged false claims made to Medicare.

Karen Drexler, on behalf of herself and the United States of America, filed a lawsuit May 12 in the U.S. District Court for the Middle District of Florida, Jacksonville Division against Mayo Clinic, Mayo Clinic Florida, Mayo Clinic Jacksonville, Dr. Frederick Kusumoto and Dr. Lakshminarayanan "K.L." Venkatachalam,  alleging violations of the False Claims Act and retaliation.

Drexler was a nurse at the Mayo Clinic campus at 4500 San Pablo Road in Jacksonville from July 2012 to June 2014. Kusumoto and Venkatachalam are the electrophysiologists at the clinic who perform catheter ablation, which is used to treat various heart problems and requires the doctors to first "map" the patient's anatomy, the complaint states.

The suit states 3-D mapping using Ensite NaVx or CARTO 3 machines results in additional reimbursement by Medicare. The clinic owns both NaVx and CARTO 3 machines but rarely uses them, instead performing only a standard 2-D mapping.

The suit states, however, that the defendants routinely bill Medicare for 3-D mapping when it performs standard 2-D mapping and also bill an "add on" charge for increased technical difficulty for all ablations.

During training on her first days on the job, Drexler was instructed always to mark 3-D mapping, even when standard 2-D mapping was performed, according to the suit. Drexler objected to this practice and, in the fall of 2012, she complained about it to supervisors, who confirmed she should always code for 3-D mapping, the suit states.

Drexler also claims she witnessed 30 to 40 instances when an under-qualified technician performed certain procedures that a doctor should have performed, but the procedure would be falsely billed to Medicare under the doctor's name.

Drexler also addressed these issues with her supervisors, after which she was ostracized and written up for negligible offenses, and ultimately was terminated in June 2014.

Drexler seeks a judgment awarding the United States treble damages and a civil penalty of $11,000 for each false claim and statement. She also seeks 30 percent of the proceeds of this action, as well as any alternate remedy or settlement, special damages, litigation costs and attorney fees. She is represented by Julie K. Bracker of Bracker and Marcus LL in Marietta, Georgia.

Drexler sued under the False Claims Act on behalf of the United States; however, the United States decided not to intervene in this case.

U.S. District Court for the Middle District of Florida, Jacksonville Division Case number 3:15-CV-00592-TJC-PDB

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