Government Intervenes in FCA Qui Tam Alleging Submission of Claims for Services Provided by Terminated Provider

On August 18, 2026, the U.S. Attorney’s Office for the Northern District of Illinois announced that the United States and the State of Illinois filed a joint complaint in intervention against podiatry practice Foot & Ankle Health Care Center; its owner, Dr. Vadim Goshko; and billing company Atlantic Wave. According to the complaint, Illinois Medicaid terminated Dr. Goshko from the Medicaid program. Because Illinois Medicaid would no longer pay claims for his services, the defendants allegedly submitted claims identifying other physicians as having provided podiatry services that were actually performed by Dr. Goshko. The complaint alleges that the defendants knowingly submitted fraudulent Medicare and Medicaid claims that caused more than $5.2 million in federal and state payments.

The government further alleges that Dr. Goshko and other defendants had an affirmative obligation to notify Medicare of his Medicaid exclusion but failed to do so. Medicare later revoked Dr. Goshko’s privileges after learning of the exclusion.

The case began as a qui tam action filed by PayrHealth, LLC, a private-equity backed billing company, which acquired the defendant billing company in December 2020. The government states that PayrHealth discovered the alleged conduct after the acquisition, terminated the Goshko entities as clients, and notified the government.

The intervention highlights the risk created when provider-enrollment status and rendering-provider information are not reconciled across payors. Medical practices and billing companies should maintain controls that confirm each clinician’s current program eligibility and ensure that every claim identifies the practitioner who actually rendered the service.

GWB represents healthcare providers in connection with government investigations and False Claims Act litigation. If you need assistance with such a matter, contact us today.