SPECIALTY CARE AND OTHER PROVIDER ENTITIES
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
Spinal decompression clinic agreed to pay more than $330,000 to resolve FCA allegations that it billed Medicare for surgical procedures involving the implantation of neurostimulator electrodes when in fact the procedures involved the non-surgical application of electro- acupuncture devices in an office setting. 82 Two affiliated adult day health centers agreed to pay more than $1 million to resolve allegations that they improperly submitted claims to Massachusetts Medicaid for services not provided or that were in excess of permissible per diem billing requirements. As part of the resolution, both centers agreed to contract with an independent compliance monitor to oversee a three-year independent compliance program. 83 Two pain management clinics agreed to pay $1.665 million to resolve FCA allegations that they engaged in a kickback scheme by causing affiliated surgery centers to waive co- payments for surgical facility fees to induce patients to receive injection procedures. The settlement also resolves allegations that the clinics improperly billed for Evaluation and Management (E&M) and psychological testing services. 84 A physical therapy company and its owner agreed to pay $152,000 to settle allegations that they billed the VA for medical devices that were not medically necessary and received kickbacks from the manufacturer of the devices in exchange for prescribing them. The government also alleged that the owner provided a copy of his signature to a salesperson, who then used it to complete medical necessity forms included with invoices and that he did not examine patients before prescribing the device. 85 Allergy and asthma treatment center agreed to pay $2.15 million to resolve FCA allegations that they double-billed and over-billed Medicare and Medicaid by combining partially used vials of an asthma treatment sold in single-use vials for use in other patients. In June 2020 the medical practice also pleaded guilty to one count of criminal healthcare fraud related to the allegations. 86
Spinal Decompression Clinic of Texas
$330,898
1/12/2021
Fun Life Adult Day Care; Monarch Elder Care
1/28/2021
$1.061 million
Collier Anesthesia Pain, LLC; Tampa Pain Relief Center, Inc.
$1.665 million
2/1/2021
Southeastern Physical Therapy; Darren Cady
2/5/2021
$152,000
Allergy and Asthma Associates, Inc.
3/2/2021
$2.15 million
82 https://www.justice.gov/usao-edtx/pr/texas-company-agrees-reimburse-medicare-improper-billing-related-neurostimulators. 83 https://www.mass.gov/news/ag-secures-more-than-1-million-from-two-adult-day-health-centers-over-allegations-of-improper. 84 https://www.justice.gov/usao-mdfl/pr/pain-clinic-pays-more-16-million-settle-false-claims-act-and-kickback-allegations. 85 https://www.justice.gov/usao-wdnc/pr/southeastern-physical-therapy-and-owner-pay-152000-settle-false-claims-allegations. 86 https://www.justice.gov/usao-wdva/pr/allergy-and-asthma-associates-roanoke-pleads-guilty-criminal-charge-enters-civil.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 62
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