Skip to main content
Nearly $37 Million False Claims Act Settlement: Semler Scientific & Bard
Table of Contents
Case Snapshot
- Total Payment: $36.95M (Semler $29.75M; Bard $7.2M)
- Core Allegations: Marketing and reimbursement guidance that allegedly caused false Medicare claims for PAD tests using FloChec/QuantaFlo, which do not perform an ABI and use photoplethysmography not covered by Medicare for noninvasive vascular tests; billing under CPT 93922/93923/93924.
- Relators’ Share: ~$6.5M
- Compliance Term: Five-year HHS-OIG Corporate Integrity Agreement
- Liability Status: No determination of liability (civil settlement) (1)
The Department of Justice (DOJ) announced that Semler Scientific Inc. and Bard Peripheral Vascular Inc. (and related entities) will pay nearly $37 million, which equates to $29.75 million by Semler and $7.2 million by Bard to resolve allegations of false Medicare claims tied to peripheral arterial disease testing performed with Semler’s FloChec and QuantaFlo devices. The DOJ emphasized the case was resolved civilly; the claims are allegations only, and there has been no determination of liability. (1)
The Allegations
According to the DOJ, Semler and Bard knowingly caused and conspired to cause false Medicare claims by promoting device usage in ways that led providers to bill under CPT codes 93922, 93923, and 93924, which require an ankle-brachial index (ABI) plus additional testing. The DOJ alleged that FloChec and QuantaFlo, in fact, do not perform an ABI and instead use photoplethysmography, a method that Medicare does not cover for noninvasive vascular tests. The alleged fraud lied in the fact that the devices were marketed as reimbursable when billed under those PAD codes. (1)
Timeline & admissions: The DOJ reports Semler made and marketed the devices from roughly 2010–2024, and Bard distributed them from 2012–2022. As part of the settlement, Bard admitted certain allegations and received cooperation credit. (1)
Speak with the Lawyers at Brown, LLC Today!
Over 100 million in judgments and settlements trials in state and federal courts. We fight for maximum damage and results.
Compliance obligations: In addition to the civil payment, Semler entered a five-year Corporate Integrity Agreement (“CIA”) with HHS-OIG, which requires Semler to comply with substantial internal compliance reforms. (1)
Whistleblowers: The case began as a qui tam action filed by two whistleblowers who are referred to as relators in False Claims Act law. The DOJ states the relators will receive about $6.5 million of the recovery as a whistleblower award for doing the right thing. (1)
Common Questions If You’re an Insider Who’s Seen Potential Billing Fraud
Can I come forward confidentially?
Yes, you can initially file your complaint confidentially, but at some point your identity in all likelihood will be disclosed. Qui tam complaints are filed under seal, meaning they are not publicly available while the government investigates. Your identity typically remains confidential during the seal period. False Claims Act cases generally take years to resolve, although some could be unsealed in a matter of months, its highly unlikely that a case would progress that quickly.
While the case is under seal, your identity is not revealed to the defendants. Once the matter becomes unsealed, then your identity will be revealed, but you will have some time to plan for that day and hopefully you will have obtained a False Claims Act settlement before it’s disclosed.
What protections exist against retaliation?
The False Claims Act provides anti-retaliation protections for whistleblowers who engage in a protected activity, such as reporting suspected fraud or assisting with aFCA case. Remedies can include reinstatement, backpay, and damages, among others. (1)
Could I receive a whistleblower award?
Yes. Whistleblowers may receive a share of the recovery when the government obtains a settlement or judgment. The DOJ notes that the Semler relators will receive approximately $6.5 million as a False Claims Act whistleblower reward. Award sizes are case-specific and tied to a range of factors, such as the usefulness of information provided, level of cooperation, and the amount of funds recovered, as well as quality of whistleblower counsel, among other factors. (1)
Why This Case Matters to Insiders
- Coding & Coverage Risk: Representing tests as reimbursable under certain CPT codes when coverage criteria were not met can trigger FCA liability. If you see internal guidance that pushes codes inconsistent with device capabilities or coverage rules, that is a red flag. (1)
- Distributor Exposure: Both the manufacturer and distributor’s conduct can be an issue when marketing or reimbursement messaging influences provider billing. (1)
- Compliance Consequences: Negotiated resolutions often include Corporate Integrity Agreements, which impose multi-year oversight and compel reforms to prevent recurrence of fraud. (1)
How to Report Suspected Health-Care Fraud
If you have information about fraud, waste, or abuse in federal health care programs, you can speak confidentially with a whistleblower law firm about filing a sealed FCA complaint and preparing the appropriate disclosures for the government.
