Healthcare Fraud & Abuse Review 2021

INDIVIDUAL PROVIDERS

DA TE

ENTITY

FCA ALLEGATIONS

AMOUNT

A dentist agreed to pay $100,000 to resolve allegations that she billed TRICARE for fillings that were not actually performed. 147

Dr. Gina Sohn

10/21/2021

$100,000

A pain management physician who was former co-owner of a pain clinic agreed to pay $2.1 million to resolve allegations that he and his clinic ordered urine drug tests conducted at the clinic’s in-house laboratory that were not medically necessary. The other co-owner of the now-defunct clinic also reached a settlement in the case. 148 A pain management physician who was former co-owner of a pain clinic agreed to pay $1.8 million to resolve allegations that he and his clinic ordered urine drug tests conducted at the clinic’s in-house laboratory that were not medically necessary. The other co-owner of the now-defunct clinic also reached a settlement in the case. 149 An anesthesiologist and pain management physician agreed to pay more than $520,000 to resolve allegations that he: (1) billed for surgical procedures involving the implantation of neurostimulator electrodes when in fact the procedures involved the non-surgical application of electro-acupuncture devices, and (2) made false statements when applying for a loan from the Paycheck Protection Program. The physician also agreed to be excluded from federal healthcare programs for seven years. 150 A pharmacist who was former owner of a pharmacy agreed to pay $275,000 to resolve allegations that he and his pharmacy filled prescriptions for controlled substances despite red flags indicating that the prescriptions were not medically necessary – specifically, they were prescribed by a doctor recently convicted for healthcare fraud and unlawfully dispensing controlled substances. 151 A physician agreed to pay $110,000 to resolve allegations that he prescribed opioids and other controlled substances without a legitimate medical purpose and outside the course of professional practice, in violation of the CSA, and caused the submission of false claims for such prescriptions. As part of the settlement, the physician agreed to certain restrictions on his ability to see new patients for whom opioids were already prescribed. 152

Dr. Robert Wills

$2.1 million

10/22/2021

Dr. Brannon Frank

$1.8 million

10/22/2021

Dr. Emad Bishai

$523,331

11/15/2021

Willie “Billy” C. Conley, Jr.

11/15/2021

$275,000

Dr. Eric Benson

$110,000

11/19/2021

147 https://www.justice.gov/usao-mdpa/pr/dentist-south-korea-pay-100000-resolve-civil-liability-violations-false-claims-act. 148 https://www.justice.gov/opa/pr/texas-pain-management-physicians-agree-pay-39-million-resolve-allegations-relating. 149 https://www.justice.gov/opa/pr/texas-pain-management-physicians-agree-pay-39-million-resolve-allegations-relating. 150 https://www.justice.gov/usao-sdtx/pr/woodlands-pain-doctor-pays-half-million-dollars-fraudulent-ppp-and-billing-allegations. 151 https://www.justice.gov/usao-sdga/pr/pharmacist-pay-275000-settle-claims-related-alleged-unlawful-dispensation-controlled. 152 https://www.justice.gov/usao-id/pr/ost-falls-doctor-pays-110000-settle-allegations-he-overprescribed-opioids.

NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 74

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