Georgina Exposito, owner of 3rd Party Services of Florida, has agreed to pay $400,000 to settle allegations that she and her company submitted false claims to Medicare and TRICARE. The settlement was announced by Acting U.S. Attorney Jay McCormack for the District of New Hampshire.
Authorities allege that Exposito and her business changed patients’ medical diagnoses in order to secure prior authorizations for pharmacies, including PerforMix Specialty Pharmacy located in Amherst. This practice allegedly led to the submission of false claims to federal health care programs.
“Submitting false claims to federal health care programs like Medicare and TRICARE undermines the integrity of our health care system and diverts critical resources away from patients who need them,” said U.S. Attorney Jay McCormack. “Accountability in cases like this helps restore trust in our health care system and ensures taxpayer dollars are protected.”
Special Agent in Charge Roberto Coviello of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), commented on the impact of these actions: “The submission of falsified prior authorization requests undermines an important safeguard against unnecessary Medicare costs,” he said. “This settlement highlights HHS-OIG’s ongoing commitment to combatting fraud in the taxpayer-funded Medicare program, and we will continue to thoroughly pursue allegations of False Claims Act violations.”
The False Claims Act allows whistleblowers to file civil lawsuits if they believe false claims have been submitted to the government. In this case, a whistleblower initiated legal action regarding Exposito’s alleged conduct; as part of the settlement agreement, that individual will receive a portion of the payment.
Officials noted that these resolved claims remain allegations only, with no determination yet made regarding liability. Legal proceedings continue against other defendants named in this matter.
The investigation involved several agencies: the Office of Inspector General at both the Department of Health and Human Services and Department of Defense, as well as the Federal Bureau of Investigation. Assistant U.S. Attorney Raphael Katz is handling the case.
