United States of America v. James A. Sakr, M.D.

Buffalo, New York civil litigation lawyers represented Defendant accused of violating the False Claims Act by frudulently billing Medicare and Medicaid for procedures that were not medically necessary or that he did not perform.



Assistant U.S. Attorney David M. Coriell, who handled the case, stated that from at least January 1, 2014, to December 31, 2019, Dr. Sakr, an ear, nose, and throat (ENT) doctor based in Dansville, NY, billed Medicare and Medicaid for procedures not performed at all or were not documented in patient medical records.



"This health care provider billed for services and procedures that he did not perform and for which he was paid with the public's money,” stated U.S. Attorney Ross. "The resolution of this case holds Dr. Sakr accountable for his actions and requires him to return the money he should not have received from Medicare and Medicaid. Our office will continue to root out fraud in federal healthcare programs and hold those who defraud the public accountable.”



The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Lee M. Mandel, M.D., FACS. 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 case is captioned United States ex rel. Mandel v. Sakr, 17-cv-907 (W.D.N.Y.). Dr. Mandel will receive a share of the settlement.



The resolution of this matter was the result of a coordinated effort between the U.S. Attorney's Office for the Western District of New York, the U.S. Department of Health and Human Services Office of Inspector General, and the New York State Attorney General's Office Medicaid Fraud Control Unit.



The False Claims Act (FCA), 31 U.S.C. §§ 3729 - 3733 was enacted in 1863 by a Congress

concerned that suppliers of goods to the Union Army during the Civil War were defrauding the

Army. The FCA provided that any person who knowingly submitted false claims to the

government was liable for double the government's damages plus a penalty of $2,000 for each

false claim. Since then, the FCA has been amended several times. In 1986, there were

significant changes to the FCA, including increasing damages from double damages to treble

damages and raising the penalties from $2,000 to a range of $5,000 to $10,000. The FCA has

been amended three times since 1986. Over the life of the statute it has been interpreted on

hundreds of occasions by federal courts (which sometimes issue conflicting interpretations of the

statute). The purpose of this primer is not to explain how the FCA evolved over the decades or

to discuss judicial interpretations of its provisions. Rather, in this primer we simply explain the

most significant elements of the FCA to give one new to the statute an introductory

understanding of the FCA and how it works.

Settled for $602,551.61.