Metro Atlanta rheumatology practice and physician agree to $2.18 million False Claims Act settlement

Settlement resolves allegations tied to infusion services and Medicare billing compliance

An Atlanta-area rheumatology practice and its owner have agreed to pay $2.18 million to resolve allegations that the practice billed Medicare for infusion services performed in a manner not permitted under Georgia law. The settlement, announced Thursday, closes a civil case brought under the federal False Claims Act and does not include a determination of liability.

The matter involves Arthritis & Rheumatology Center, P.C., and Jatin Patel, M.D. Federal authorities said the allegations centered on the use of medical assistants to perform infusion services despite state rules restricting who may administer such care. The government position in the case was that Medicare does not reimburse for services provided in violation of applicable state law, and that claims submitted for such services can therefore be considered false under the False Claims Act.

How the case began: a whistleblower filing and a federal civil lawsuit

The investigation began after a former employee filed a whistleblower complaint, alleging that unlicensed medical assistants were used to administer infusion treatments, including medications described by authorities as powerful chemotherapy drugs. The civil lawsuit was filed in the U.S. District Court for the Northern District of Georgia under the False Claims Act’s qui tam provisions, which allow private individuals to sue on behalf of the United States and share in any recovery.

The whistleblower in the case, identified in court records as Phillips Allender, is set to receive $414,200 from the settlement proceeds.

The settlement resolves allegations only; no court finding established that the defendants violated the law.

Why state licensing rules matter to federal billing

The case highlights a key compliance principle in federal health care payment programs: Medicare coverage and reimbursement are conditioned not only on medical necessity and documentation, but also on whether services were delivered in accordance with governing laws and regulations, including state licensing requirements. When a service is provided by personnel not authorized to perform it under state rules, the federal program may deem resulting claims non-payable.

What comes next

The settlement concludes the federal civil allegations against the practice and the physician regarding the conduct described in the complaint. While the payment resolves the case, it also underscores ongoing federal scrutiny of clinical staffing, supervision, and billing practices—especially for high-risk services such as infusions that require specific qualifications and oversight.

• Parties: Arthritis & Rheumatology Center, P.C., and Jatin Patel, M.D.
• Amount: $2.18 million
• Court: U.S. District Court for the Northern District of Georgia
• Statute: False Claims Act