Healthcare Fraud & Abuse Review 2021

INDIVIDUAL PROVIDERS

DA TE

ENTITY

FCA ALLEGATIONS

AMOUNT

A physician agreed to pay $1 million to resolve allegations that he billed Medicare and TennCare for an electro-acupuncture stimulation device as if the device had to be implanted surgically when it did not. The physician entered into a three-year IA with HHS-OIG as part of the resolution. 117

Dr. James P. Anderson

1/4/2021

$1 million

Charles F. Spencer; Total Family Physicians Center PLLC d/b/a Total Family Health & Wellness

A chiropractor and his medical group agreed to pay $700,000 to resolve allegations that they billed Medicare and TennCare for an electro-acupuncture stimulation device as if the device had to be implanted surgically when it did not. 118

1/4/2021

$700,000

A chiropractor and his medical group agreed to pay $20,000 to resolve allegations that he billed Medicare and TennCare for an electro-acupuncture stimulation device as if the device had to be implanted surgically when it did not. 119 A urologist's estate agreed to pay $1.75 million to resolve allegations that he billed for kidney stone procedures that were not medically necessary because they were not medically indicated or because no kidney stones were in the patients. The settlement also resolved allegations that the urologist performed the procedures at a surgery center from which he allegedly received kickback payments. 120 A management services company, its owner and a medical practice agreed collectively to pay $150,000 to resolve allegations that they submitted claims to Medicare for the surgical implantation of neurostimulation devices when electro-acupuncture devices that were not surgically implanted were used. 121 A business owner and her company agreed to pay more than $20 million to resolve allegations that they fraudulently established DME companies by submitting falsified paperwork. The companies then allegedly billed Medicare for equipment that was not medically necessary and used marketing techniques that violated the AKS. In addition to the civil settlement, the owner pleaded guilty to related criminal charges. 122

Mitchell P. Shea; Chiro2Med of Tennessee P.C.

$20,000

1/4/2021

Estate of Dr. Patrick T. Hunter

$1.75 million

1/22/2021

Elevani Health Group, PLLC; Agilium, Inc.; Chad Glines

1/25/2021

$150,000

Kelly Wolfe; Regency Inc.

2/4/2021

$20.333 million

117 https://www.justice.gov/usao-mdtn/pr/united-states-and-tennessee-resolve-claims-three-providers-false-claims-act-liability. 118 https://www.justice.gov/usao-mdtn/pr/united-states-and-tennessee-resolve-claims-three-providers-false-claims-act-liability. 119 https://www.justice.gov/usao-mdtn/pr/united-states-and-tennessee-resolve-claims-three-providers-false-claims-act-liability. 120 https://www.justice.gov/usao-mdfl/pr/estate-deceased-urologist-agrees-pay-more-17-million-settle-false-claims-act-liability. 121 https://dockets.justia.com/docket/texas/txndce/3:2021cv00157/343353. 122 https://www.justice.gov/opa/pr/florida-businesswoman-pleads-guilty-criminal-health-care-and-tax-fraud-charges-and-agrees-203.

NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 69

Powered by