Acting United States Attorney Richard. G. Frohling announced on October 27, 2021 that Samir Mullick, MD, SC, which does business as Pediatric Associates, and its owner Dr. Samir Mullick, agreed to pay $706,599 to resolve allegations that Pediatric Associates submitted false claims to Medicaid for unnecessary treatment and visits.
According to court records, Pediatric Associates operates three pediatric clinics in the Milwaukee area. The United States alleged that Pediatric Associates, under the direction of Dr. Mullick, submitted claims to Medicaid that relied on falsified diagnosis codes to justify unnecessary and otherwise non-reimbursable office visits. The United States further alleged that Pediatric Associates submitted claims for medically unnecessary testing and treatment, with disparate and more aggressive testing protocols for patients with Medicaid coverage as opposed to privately-insured patients.
“The U.S. Attorney’s Office prioritizes efforts to stop healthcare fraud and is committed to working with our federal, state, and local partners to protect health care program beneficiaries and the American taxpayers,” said Acting United States Frohling. “This settlement demonstrates our continuing efforts to combat violations of the False Claims Act.”
“Medical providers must ensure that the services they provide and bill for are medically necessary,” said Mario Pinto, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “The OIG will continue to identify and investigate allegations of potential fraudulent billing to the Medicaid program in order to protect the health and safety of patients and vital taxpayer dollars.”
The government’s investigation resulted from a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. Accordingly, the whistleblower will receive a share of the settlement amount. As part of the settlement, the government and the whistleblower will ask the district court to dismiss the whistleblower’s qui tam complaint.
Assistant United States Attorney Maura Flaherty represented the government in this matter. The investigation was assisted by HHS-OIG and the Wisconsin Department of Justice Medicaid Fraud Control & Elder Abuse Unit. The settlement agreement states allegations only; the defendants do not admit liability for the allegations.