Local doctor is whistleblower in Medicare fraud case
An Alexandria physician triggered a federal investigation of suspected Medicare fraud at a Wheaton hospital that resulted in a settlement of $846,461 with the U.S. government.
Dr. Steven Radjenovich, who owns and operates the Midway Medical Clinic in Alexandria, is being credited as the "whistleblower" in the case.
He filed a federal lawsuit accusing the Wheaton Community Hospital, where he once worked, of violating the False Claims Act. The suit sparked a federal investigation that concluded that Medicare had been billed for years for unnecessary treatments.
Radjenovich will receive $203,150 under a federal law that entitles people who uncover wrongdoing to a share of the funds recovered by government.
Radjenovich declined to comment for this story.
The Wheaton Community Hospital agreed to settle the lawsuit that claimed it fraudulently billed Medicare for "unreasonable and unnecessary" hospitalizations, according to the U.S. Department of Justice, which announced the news Monday.
Although it agreed to settle the lawsuit, the hospital denied any wrongdoing.
Nicole Moen, a lawyer for Dr. Stanley Gallagher who was once the hospital's chief of staff, told the media that Gallagher was a dedicated country doctor looking out for his patients' best interests.
"While the government would have cut off hospitalization, Dr. Gallagher cares deeply about his patients, most of whom are elderly," Moen said in a Star Tribune story, "and he wouldn't admit a patient or keep a patient in the hospital if it was not in the patient's best interests."
The government's investigation examined 170 randomly selected patient records over a seven-year period, from 1998 to 2004, and concluded that many admissions were unnecessary, according to the complaint.
Three elderly patients, for example, were admitted to the hospital's acute care unit but received only oral pain killers and physical therapy, investigators alleged.