Healthcare Fraud

May 7, 2020

Seattle Pain Center, Northwest Analytics, and owner/physician Dr. Frank Danger Li have agreed to pay $2.85 million to settle allegations of defrauding Washington’s Medicaid program.  An investigation revealed that between 2013 and 2015, Li had instituted a policy required nearly every patient treated at Seattle Pain Center to be administered the full urine drug panel at each visit even if they were not medically necessary.  The drug tests were then sent to Li’s exclusively-owned laboratory to be analyzed.  Additionally, the investigation revealed that between 2007 and 2016, Li wrote an excessive amount of prescriptions for opioids, and at least 60 of his patients died due to opioid-related causes during this period.  AG WA; USAO WDWA

May 1, 2020

Milwaukee-based Center for Pain Management, S.C. and its owner, Nosheen Hasan, will pay at least $1.35 million to resolve claims that they received unlawful kickbacks in exchange for ordering medically unnecessary tests from a urine drug testing laboratory, Midwest Laboratory Sales & Consulting, LLC, in violation of the False Claims Act.  The investigation was initiated by a whistleblower, who will receive a share of the settlement.  USAO ED WI

April 30, 2020

Oncology practice group Florida Cancer Specialists & Research Institute LLC entered into a deferred prosecution agreement admitting to a criminal antitrust conspiracy in the form of an agreement with another provider not to compete to provide chemotherapy and radiation treatments to cancer patients in southwest Florida.  FCS will pay a $100 million criminal penalty and cooperate with ongoing federal antitrust investigations into market allocation and other anticompetitive conduct in the oncology industry.  DOJ

April 29, 2020

North Carolina physician Ibrahim Oudeh and his wife Teresa Sloan-Oudeh will pay up to $8.8 million to resolve claims of Medicare and Medicaid fraud.  Between 2010 and 2017, the Oudehs reportedly submitted more than 40,000 false claims, including more than 37,000 claims for laboratory tests, including nerve-conduction studies that Dr. Oudeh was not qualified to interpret, the vast majority of which were medically unnecessary.  To submit as many claims as they did, defendants falsely billed for office visits, in some instances billing for more than 24 hours of visits in a single calendar day.  The Oudehs sometimes used outside physicians to interpret laboratory tests, but paid those physicians less than their practice’s Medicare reimbursement, a violation of the Anti-Markup Rule.  Defendants will forfeit $3.3 million in assets and pay an additional $5.5 million.   USAO EDNC; NC

April 27, 2020

North Carolina based clinical laboratory Genova Diagnostics Inc. will pay up to $43 million to resolve a lawsuit brought by whistleblower Darryl Landis, who will receive up to $6 million.  The laboratory allegedly billed Medicare, TRICARE, and other government healthcare programs for IgG allergen, “NutrEval,” and “GI Effects” lab tests that were not medically necessary, and also paid unlawful compensation to three phlebotomy vendors in violation of the Stark Law  The settlement amount consists of the forfeiture of $17 million in claim funds held in suspension by Medicare and TRICARE, as well as an additional $26 million to be paid based on certain financial contingencies over the next five years.  DOJ; USAO WD NC