INDIVIDUAL PROVIDERS
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
A chiropractor agreed to pay more than $290,000 to resolve allegations that he billed the U.S. Department of Labor's Office of Workers’ Compensation Programs for extended medical examination services provided to a federal employee receiving Federal Employees Compensation Act benefits, when the services were not actually provided at the level billed. 141 A cardiologist agreed to pay $6.75 million to resolve allegations that he billed for medically unnecessary ablations and vein stent procedures, often performed by technicians who were not qualified to administer the procedures, and, to justify the treatments, the cardiologist made misrepresentations in medical records. The physician and his practice concurrently entered into a three-year IA with HHS-OIG as part of the resolution. 142 A physician agreed to pay $2 million to resolve allegations that he prescribed controlled substances without a valid medical purpose, in violation of the CSA, and many of these prescriptions were paid for by Medicaid and Medicare, resulting in FCA violations. The physician also pleaded guilty to related criminal charges and will be excluded from participating in Medicare for at least 10 years. 143 A Certified Registered Nurse Practitioner agreed to pay $21,000 to resolve allegations that she received a per-patient consulting fee from a marketing company in exchange for ordering DME for patients with whom she did not have an existing relationship and without any physical examination of the patients. 144 An internal medicine physician agreed to pay $640,000 to resolve allegations that he received fees as a medical director of a former home health agency that were above FMV and based on his referral of patients to the agency, in violation of the AKS. 145 The former CEO of a now-defunct medical testing laboratory agreed to pay $1.1 million to resolve kickback allegations that the lab received payments from at least two other laboratories in exchange for the referrals of testing for beneficiaries of government healthcare programs which his lab was not eligible to conduct. The laboratories paying for the referrals previously reached settlements in the matter, and the CEO pleaded guilty to related criminal charges. 146
Gary Stein
8/25/2021
$290,197
Dr. Ashish Pal
9/15/2021
$6.75 million
Dr. Stephen Padnes
$2 million
9/28/2021
Kate Cordisco
10/1/2021
$21,000
Dr. Llewellyn Simon
10/12/2021
$640,000
Jae Lee
10/18/2021
$1.1 million
141 https://www.justice.gov/usao-edny/pr/long-island-chiropractor-settles-federal-fraud-allegations. 142 https://www.justice.gov/usao-mdfl/pr/orlando-cardiologist-pays-675-million-resolve-allegations-performing-unnecessary. 143 https://www.justice.gov/usao-edpa/pr/center-city-doctor-pleads-guilty-illegally-distributing-controlled-substances-and. 144 https://www.justice.gov/usao-mdpa/pr/certified-registered-nurse-practitioner-pay-21000-resolve-civil-liability-alleged. 145 https://www.justice.gov/usao-wdla/pr/physician-agrees-pay-640000-resolve-allegations-anti-kickback-violations. 146 https://www.justice.gov/usao-wdwa/pr/doj-and-ceo-defunct-medical-testing-laboratory-settle-false-claims-act-and-anti.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 73
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