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Physician Settles False Claims Allegations for $3.5 Million

News RoomBy News RoomJanuary 23, 2025Updated:January 24, 20253 Mins Read
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Physician Settles for $3.5 Million in False Claims and Controlled Substances Act Case

NEW YORK – Dr. Kamal Kabakibou and his medical practice, Kamal Kabakibou, M.D., P.C., have agreed to a $3.5 million settlement to resolve allegations of False Claims Act and Controlled Substances Act violations, the Department of Justice announced Thursday. The settlement stems from a multifaceted investigation into Dr. Kabakibou’s billing practices and prescription dispensing protocols, which allegedly involved medically unnecessary testing and the unlawful pre-signing of controlled substance prescriptions, including potent opioids. The resolution of this case underscores the government’s ongoing commitment to combating healthcare fraud and safeguarding patient safety.

The Justice Department’s investigation revealed a pattern of questionable billing practices by Dr. Kabakibou. The government alleges that he subjected patients to a barrage of unnecessary and often redundant laboratory tests, subsequently billing federal health insurance programs, including Medicare and Medicaid, for these procedures. This alleged scheme resulted in significant financial losses for the government and exposed patients to potentially unwarranted medical interventions. The settlement amount reflects the gravity of these alleged violations and the government’s resolve to hold healthcare providers accountable for fraudulent billing practices.

Furthermore, the settlement addresses serious concerns regarding Dr. Kabakibou’s prescription practices. According to the Department of Justice, when Dr. Kabakibou was traveling abroad, he would pre-sign prescriptions, including those for Schedule II controlled substances such as opioids. These pre-signed prescriptions were then dispensed by his nurse practitioners. This practice violated the Controlled Substances Act, which prohibits the dispensing of Schedule II controlled substances by unsupervised nurse practitioners. The pre-signing of these prescriptions posed a significant risk to patient safety and contributed to the ongoing opioid crisis.

The settlement resolves allegations initially brought forth in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. This provision empowers private citizens with knowledge of fraud against the government to file suit on behalf of the United States and share in any recovery. The whistleblower in this case, a former employee of Dr. Kabakibou’s practice, will receive a portion of the settlement, highlighting the critical role whistleblowers play in uncovering fraud and protecting taxpayer dollars. The specific amount of the whistleblower’s share was not disclosed.

This case serves as a significant reminder of the importance of compliance with healthcare regulations and the severe consequences of fraudulent activities within the healthcare system. The Department of Justice continues to prioritize investigations into healthcare fraud, particularly schemes involving medically unnecessary procedures and the improper prescribing of controlled substances. The $3.5 million settlement with Dr. Kabakibou sends a clear message to healthcare providers that such practices will not be tolerated.

The settlement agreement not only recovers substantial funds for the government but also includes measures to prevent future violations. While Dr. Kabakibou did not admit liability as part of the settlement, the agreement requires his practice to implement enhanced compliance procedures to ensure adherence to all applicable laws and regulations. These measures will help protect patients from unnecessary procedures and ensure the responsible handling of controlled substances. The Department of Justice will continue to monitor Dr. Kabakibou’s practice to ensure compliance with the terms of the settlement. The settlement underscores the government’s multifaceted approach to combating healthcare fraud, encompassing both enforcement actions and proactive measures to prevent future wrongdoing.

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