INDIVIDUAL PROVIDERS
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
The former owner and sole-shareholder of a children's autism therapy provider agreed to pay more than $2.7 million to resolve allegations that nine of the company's locations submitted claims to TRICARE that: (1) did not correctly identify the provider of services; (2) could not be substantiated by medical records; or (3) covered services allegedly provided on dates when the individual providers billed excessive hours. 129 A former owner of a diagnostic testing laboratory agreed to pay more than $2 million to resolve allegations that he caused the now-defunct laboratory to submit false claims to Medicare by participating in the following kickback schemes: (1) providing urine drug testing equipment to two physicians; (2) the laboratory paying an individual volume-based commission and then a salary in exchange for the individual working with physician groups to induce referrals; and (3) providing loans to two physicians in exchange for referrals. 130 A former owner of a now-defunct diagnostic testing laboratory entered a consent judgment to pay $4.5 million to resolve allegations that he paid kickbacks to the owner of a medical practice in exchange for referrals to the company's laboratories. 131 The CFO of a physical medicine clinic and licensed chiropractor, agreed to pay $273,000 to resolve allegations that her clinic billed Medicare for surgical procedures involving the implantation of neurostimulator electrodes, when the procedures performed were actually the non-surgical application of electro-acupuncture devices. 132 A family practice physician agreed to pay more than $660,000 to resolve allegations that she billed Medicare for the surgical implantation of neurostimulator devices when the patients received acupuncture devices that were not surgically implanted. 133 Two dentists, their dental management companies, and certain affiliated pediatric dental practices agreed to pay $3.1 million to resolve allegations that they billed the Texas Medicaid for fillings in children that were not actually performed. The settlement also resolves allegations that they submitted or caused the submission of claims using erroneous Medicaid provider numbers misrepresenting the dentists who performed pediatric procedures. 134
Dr. Domonique Randall
3/23/2021
$2.729 million
Philip McHugh
3/26/2021
$2.022 million
Douglas Smith
3/30/2021
$4.5 million
Stacy Hawkins
4/7/2021
$273,000
Dr. Njideka Udochi
4/19/2021
$663,094
Dr. Gunjan Dhir; Dr. Gaurav Puri
$3.1 million
5/14/2021
129 https://www.justice.gov/usao-sdtx/pr/former-children-s-autism-service-provider-pays-over-27-million-resolve-health-care. 130 https://www.justice.gov/usao-wdnc/pr/owner-defunct-urine-drug-testing-laboratory-agrees-pay-over-2-million-resolve. 131 https://www.justice.gov/usao-wdnc/pr/court-enters-45-million-judgment-against-owner-defunct-urine-drug-testing-laboratory. 132 https://www.justice.gov/usao-sdtx/pr/chiropractor-pays-settle-allegations-arising-electro-acupuncture-device-billing. 133 https://www.justice.gov/usao-md/pr/howard-county-physician-pays-more-660000-resolve-false-claims-act-allegations-fraudulent. 134 https://www.justice.gov/usao-ndtx/pr/dentists-pay-31-million-resolve-allegations-they-submitted-false-claims-services-not.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 71
Powered by FlippingBook