SPECIALTY CARE AND OTHER PROVIDER ENTITIES
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
Two pain clinics, their owners and a former employee agreed to pay $163,400 to resolve FCA allegations that they improperly billed Medicare for a procedure involving electro-acupuncture devices using a code that indicated the devices were surgically implanted when in fact they were not. The clinics and their owners entered into a three-year IA with HHS-OIG as part of the resolution. 109 Physician-owned primary and urgent care practice agreed to pay $1.25 million to resolve FCA allegations that its clinics billed federal healthcare programs for medically unnecessary services and falsified medical records to support the claims. The settlement also resolves allegations that the practice created a protocol that resulted in the systematic billing of medically unnecessary kidney dysfunction tests by adding the test to a panel run on most of its patients. 110 Pediatric clinic chain and its owner agreed to pay more than $700,000 to resolve FCA allegations that they submitted claims to Medicaid for medically unnecessary testing and treatments as well as claims that relied on falsified diagnosis codes to justify unnecessary and otherwise non-reimbursable office visits. 111 Physical therapy provider agreed to pay $4 million to resolve FCA allegations that it improperly billed federal healthcare programs for one-on-one outpatient therapy sessions that were not provided. 112
Align Health and Holistic Medical Center, Inc.; Align Health Management, Inc.; Eric Anderson, P.A. d/b/a Anderson Chiropractic Clinic
9/21/2021
$163,400
Colonial Family Practice, LLC
10/20/2021
$1.25 million
Samir Mullick, MD, SC d/b/a Pediatric Associates; Dr. Samir Mullick
$706,599
10/27/2021
RehabAuthority, LLC
10/28/2021
$4 million
Infectious Disease Consultants of Georgia
An infectious disease clinic agreed to pay $325,000 to resolve FCA allegations that it billed Medicare for infusion services that were provided by unlicensed or unapproved individuals. 113
11/1/2021
$325,000
109 https://www.justice.gov/usao-edtn/pr/local-providers-agree-settle-allegations-improper-billing-electro-acupuncture-devices. 110 https://www.justice.gov/usao-sc/pr/united-states-reaches-125-million-settlement-south-carolina-family-practice-clinics. 111 https://www.justice.gov/usao-edwi/pr/pediatric-associates-samir-mullick-md-sc-and-dr-samir-mullick-agree-pay-over-700000. 112 https://www.justice.gov/usao-mn/pr/physical-therapy-provider-pay-4-million-resolve-alleged-false-claims-act-violations. 113 https://www.justice.gov/usao-mdga/pr/infectious-disease-clinic-agrees-pay-325k-resolve-fraud-claims.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 67
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