Listen to the article
Troy Sleep Clinic Settles False Claims Allegations for $763,954
A Troy-based sleep center and its associated medical equipment company, along with two physicians, have agreed to pay more than $763,000 to resolve allegations they violated the False Claims Act by improperly billing federal healthcare programs.
United States Attorney Jerome Gorgon Jr. announced that Troy Sleep Center PLC, Care One Medical Equipment and Supplies, Inc., and physicians Michel Alkhalil, MD and Peggy Rahal, MD will pay $763,954.74 to settle claims brought by both the federal government and the State of Michigan.
According to the US Attorney’s Office for the Eastern District of Michigan, the allegations center around two main issues. First, investigators claim that between January 2018 and December 2024, Drs. Alkhalil and Rahal billed federal healthcare programs for sleep studies that were conducted without properly trained and certified sleep technicians as required by federal regulations.
The second allegation involves Care One Medical Equipment and Supplies improperly billing Medicaid for PAP (Positive Airway Pressure) machine accessories from January 2018 through May 2024. Under Medicaid regulations, these accessories cannot be billed separately from PAP machine rental rates.
Federal authorities also noted that Drs. Alkhalil and Rahal allegedly obtained approximately $480,000 in Paycheck Protection Program loans connected to the improper billing practices. The PPP was designed to help small businesses maintain their workforce during the COVID-19 pandemic.
“Billing federal health care programs for services that do not meet required standards compromises patient care and erodes public trust,” said Mario Pinto, special agent in charge at the US Department of Health and Human Services Office of Inspector General, in a statement. “Together with our law enforcement partners, we remain steadfast in our commitment to identify and stop fraud that threatens patient well-being and misuses taxpayer dollars.”
The settlement resolves claims initially brought forward under a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. These provisions allow private citizens to file lawsuits on behalf of the government and share in any financial recovery when they expose fraud against federal programs.
Sleep disorder clinics represent a growing sector in healthcare as awareness of conditions like sleep apnea has increased in recent years. The American Sleep Association estimates that 50-70 million US adults have a sleep disorder, with obstructive sleep apnea affecting 25 million Americans. This has created a substantial market for both diagnostic services and treatment equipment like CPAP and BiPAP machines.
Medical billing fraud has been a significant focus for federal investigators in recent years. The Department of Justice recovered over $2.2 billion from False Claims Act cases in 2022 alone, with healthcare fraud making up the majority of those recoveries.
The settlement with Troy Sleep Center and the associated parties comes amid heightened scrutiny of healthcare billing practices nationwide. Federal authorities have increasingly targeted improper billing for diagnostic tests and durable medical equipment as areas of particular concern.
While the financial settlement has been reached, the Department of Justice emphasized that the claims resolved are allegations only, and there has been no determination of liability in the case. Neither Troy Sleep Center nor the physicians have admitted wrongdoing as part of the settlement agreement.
The case highlights the importance of compliance with federal regulations in healthcare billing, particularly in specialized fields like sleep medicine where specific certifications and protocols must be followed to ensure patient safety and proper use of government funds.
Fact Checker
Verify the accuracy of this article using The Disinformation Commission analysis and real-time sources.
12 Comments
It’s good to see the government taking action against healthcare providers that engage in fraudulent billing practices. Violations like these can drive up costs for patients and payers. I hope this serves as a warning to others in the industry to strictly follow all applicable rules and regulations.
Absolutely. Enforcing compliance is crucial to maintaining the integrity of federal healthcare programs. This settlement should motivate providers to review their billing procedures and staffing to ensure they are meeting all requirements.
A settlement of nearly $800,000 is a significant amount for a sleep clinic and medical equipment supplier. This case demonstrates the government’s commitment to cracking down on healthcare fraud and protecting the integrity of federal programs. It will be interesting to see if there are any further regulatory or legal actions taken as a result.
Agreed. The large settlement amount suggests the violations were quite substantial. It will be worth monitoring whether this leads to any policy changes or increased scrutiny of sleep clinics and DME suppliers going forward.
The allegations of improperly billed sleep studies and PAP accessories are concerning. It’s reassuring to see the government taking action to recoup the funds and deter future false claims. Curious to know if this was an isolated incident or part of a broader pattern.
Good point. Identifying any systemic issues will be important to prevent similar violations in the future and ensure patients receive proper care. The settlement amount suggests this was a significant case.
The details around the improper sleep study staffing and PAP accessory billing are concerning. I wonder if there were any patient safety issues that contributed to the government’s decision to pursue this case. Ensuring quality of care should be a top priority for healthcare providers.
Good point. Patient welfare is paramount, so any potential risks to patients from the alleged violations would be an important factor. The settlement likely reflects the gravity of the situation beyond just the financial impact.
This is a substantial settlement for a sleep clinic and medical equipment supplier. The violations around sleep study staffing and PAP accessory billing seem fairly straightforward. I wonder if there were any aggravating factors that led to the large payout.
You raise a good question. The details around the scope and duration of the false claims could shed light on why the settlement amount was so high. Regulatory compliance is clearly an area that healthcare providers need to closely monitor.
This settlement highlights the importance of following billing regulations and ensuring proper certification for sleep studies. It’s good to see the government holding healthcare providers accountable for false claims. Curious to learn more about the specific issues that led to this case.
Agreed, compliance with billing rules and staffing requirements is critical for healthcare providers. The details on the improper billing for sleep studies and PAP accessories provide valuable lessons for the industry.