BioTelemetry and LifeWatch to Pay More than $14.7 Million to Resolve False Claims Act Allegations that LifeWatch Billed More Expensive Services than Physicians Intended to Order

PHILADELPHIA – BioTelemetry, Inc. and its subsidiary, LifeWatch Services, Inc., headquartered in Malvern, Pennsylvania and Rosemont, Illinois, respectively, have agreed to pay $14,734,628 to resolve allegations that they violated the False Claims Act when LifeWatch, through its marketing and enrollment process for remote cardiac monitoring services, knowingly submitted false claims to federal health care programs for a higher level of remote cardiac monitoring service than physicians had intended to order or which was medically necessary, thus resulting in a higher level of reimbursement to LifeWatch.

Specifically, the United States contends that, during the period July 1, 2014 through December 31, 2020, Defendants marketed LifeWatch’s ACT-3L device (also known as the LifeStar ACT-3L and the MCT-3L) to doctors as being capable of performing three different types of heart monitoring services: Holter, event monitoring, and telemetry. Of these, Holter provided the lowest rate of reimbursement from federal healthcare programs, and telemetry provided the highest rate of reimbursement. 

The United States contends that Defendants knew the design of LifeWatch Connect (the online enrollment portal for this device) caused unwitting clinical staff to select options that would enroll the patient in telemetry, even when the doctor intended to order a less expensive service. The United States also contends that Defendants’ sales personnel instructed clinical staff to select these options—even when Defendants knew the clinic’s physicians intended to order event monitoring for many or all patients—and then provided and billed for telemetry services.  Defendants also allegedly disregarded notes clinics included in their enrollments that specifically requested event monitoring and did not consistently comply with clinics’ instructions about the appropriate handling of their enrollments, even after such issues were brought to Defendants’ attention.

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 Jacqueline C. Romero, United States Attorney 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.”

“Companies are required to submit accurate claims based on patient needs,” said Maureen R. Dixon, Special Agent in Charge of the Philadelphia Regional Office of the Department of Health and Human Services, Office of the Inspector General. “HHS-OIG will continue to work with the U.S. Attorney’s Office and our law enforcement partners, to investigate allegations of the False Claims Act.”

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 Defendants’ customers, and SFP I, LLC. 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 United States ex rel. SFP I, LLC v. LifeWatch Corp., et al., No. 2:19-cv-2169 (E.D. Pa.) and United States ex rel. Pelletier et al. v. LifeWatch Services, Inc., et al., No. 2:18-cv-11391 (D.N.J.). The EDPA qui tam resolved for $1.78 million.

The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the United States Attorney’s Offices for the Eastern District of Pennsylvania and the District of New Jersey, with assistance from HHS-OIG, the Department of Defense’s Defense Criminal Investigative Service, the Department of Veterans Affairs Office of Inspector General and the Office of Personnel Management’s Office of Inspector General.

The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud.  One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The EDPA matter was handled by Assistant U.S. Attorney Erin Lindgren and Auditor Dawn Wiggins.

The claims resolved by the settlement are allegations only and there has been no determination of liability.