January 11, 2023

Mitias to pay $1.87 million over allegations of Medicare and Medicaid overbilling

Darkhorse Press

Mitias Orthopaedics, PLLC, it’s owner Dr. Hanna “Johnny” Mitias, and a subsidiary Champion Orthopedics, have agreed to pay $1,870,714.83 to resolve allegations the orthopedic health services providers knowingly submitted false claims to Medicare and Medicaid, the Department of Justice announced today.

“Taxpayers deserve to receive the products and services billed to their federal health insurance programs.  The viability of Medicare and Medicaid is threatened by each wasted dollar. Our people come before profits,” said United States Attorney Clay Joyner.  “This settlement sends a clear message that the Department of Justice will hold healthcare providers accountable if they knowingly overbill federal healthcare programs.”

Between Jan. 1, 2008, and Dec. 31, 2015, Mitias and his clinics allegedly submitted false claims to the Medicare and Medicaid programs for brand name viscosupplementation agents for knee injections that were not administered to the beneficiaries of those programs.  Rather, a much cheaper, compounded viscosupplementation agent was alleged to have been used and, as a result, the defendants improperly claimed compensation for the higher priced products.

“We are committed to thoroughly investigating claims of fraud and holding health care providers accountable when they break the rules. The public should know we will devote the necessary time and effort to stamp out healthcare fraud in both civil and criminal matters,” said Joyner.  “This settlement is an example of how whistleblowers and the government can work together to recoup and deter overbilling practices.”

The settlement resolves allegations in a 2015 lawsuit by a medical device sales representative filed under the whistleblower provisions of the False Claims Act.  Those provisions permit private individuals to sue on behalf of the government for false claims and to share in any recovery.

The settlement was the result of a coordinated effort by the Civil Division of the Department of Justice, the United States Attorney’s Office for the Northern District of Mississippi, the Department of Health & Human Services, Office of Inspector General, and the State of Mississippi Attorney General’s Office Medicaid Fraud Control Unit.

The case is captioned United States ex rel. Gray v. Mitias Orthopaedics, PLLC (3:15-cv-127). The claims resolved by the settlement are allegations only and there has been no determination of liability.

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