SPECIALTY CARE AND OTHER PROVIDER ENTITIES
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
A pain management practice and its physician owner agreed to pay $500,000 to resolve FCA allegations that they billed Medicare and Medicaid for medically unnecessary diagnostic nerve conduction tests that were often performed by unqualified staff, despite coverage rules requiring a physician perform the tests. The practice and physician owner entered into a three-year IA with HHS-OIG as part of the resolution. 92 Chiropractic clinic and its chiropractor owner agreed to pay $2.6 million to resolve allegations that they billed Medicare and TRICARE for surgical procedures involving the implantation of neurostimulator devices when in fact the procedures involved the non- surgical application of electro-acupuncture devices in an office setting. As part of the resolution, the clinics and chiropractor owner are excluded from participation in federal healthcare programs for 10 years. 93 A medical group agreed to pay more than $338,000 to resolve self-disclosed FCA allegations that it billed Medicare for surgical procedures involving the implantation of an electro-acupuncture device when in fact the devices were not implanted and no surgery was performed. 94 Chiropractic practice, chiropractor and his affiliate agreed to pay $662,492 to resolve FCA allegations that they billed federal healthcare programs for surgical procedures involving the implantation of neurostimulator devices when in fact the procedures involved the non-surgical application of electro-acupuncture devices in an office setting. 95 Chiropractic practice and two chiropractors agreed to pay $143,486 to resolve FCA allegations that they billed federal healthcare programs for surgical procedures to implant neurostimulator electrodes when the procedures performed were actually the non-surgical application of a device. 96
HEAG Pain Management Center, P.A.; Dr. Kwadwo Gyarteng-Dakwa
5/26/2021
$500,000
Campbell Medical Group PLLC; Johnson Medical Group PLLC d/b/a Campbell Medical Clinic; Suhyun An
6/8/2021
$2.6 million
SPR Medical Group (f/k/a Atlas Medical Group) d/b/a Superior Physical Medicine
$338,150
6/10/2021
Discover Optimal Healthcare; Weigner Healthcare Management Group, LLC; Jason Weigner
$662,492
6/11/2021
Yucha Medical Pain Management & Chiropractic Rehabilitation, LLC; Randolph E. Yucha; Rodney Gabel
$143,486
6/11/2021
Park Square Urgent Care, Inc.; Primacare, Inc.; Biltmore Medical; Biltmore Medical A; Advanced Urgent Care; Zaheer Shah, M.D.
Urgent care center, a physician and affiliated entities agreed to pay $650,000 to resolve allegations that they submitted claims to Medicare and Medicaid for more complex urine drug testing than they actually performed. 97
$650,000
6/14/2021
92 https://www.justice.gov/usao-mdnc/pr/greensboro-physician-and-pain-management-practice-pay-500000-resolve-allegations-health. 93 https://www.justice.gov/usao-sdtx/pr/wrongful-billing-results-26m-settlement-and-10-year-exclusion-federal-health-care. 94 https://www.justice.gov/usao-wdtx/pr/healthcare-practitioners-pay-over-1-million-resolve-false-claims-act-liability-arising. 95 https://www.justice.gov/usao-edpa/pr/two-pa-chiropractic-practices-pay-over-800000-resolve-alleged-false-claims-act. 96 https://www.justice.gov/usao-edpa/pr/two-pa-chiropractic-practices-pay-over-800000-resolve-alleged-false-claims-act. 97 https://www.justice.gov/usao-ri/pr/us-recovers-650000-local-providers-who-billed-medicare-and-medicaid-screening-tests-not.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 64
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