Medicare
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June 11, 2021
Two integrative chiropractic practices in Pennsylvania and their chiropractor owners have agreed to pay over $800,000 to resolve liability under the False Claims Act in connection with an electro-acupuncture device. The settling parties are Discover Optimal Healthcare, affiliate Weigner Healthcare Management Group, LLC, and owner Jason Weigner (collectively, “Weigner”), and Yucha Medical Pain Management & Chiropractic Rehabilitation, LLC, and owners Randolph Yucha and Rodney Gabel. Between 2016 and 2017, the parties allegedly billed Medicare and the Federal Employees Health Benefit Program for the surgical implantation of neuro-stimulators, even though the devices involved—ANSiStim—are not reimbursable and can be applied with adhesives. USAO EDPAJune 10, 2021
Three Texas-based healthcare providers who allegedly billed Medicare for non-reimbursable procedures involving electro-acupuncture devices have agreed to pay over $1 million in settle their liability under the False Claims Act. For up to two years, each of the providers—Ledger Foot & Ankle, P.A., SPR Medical Group d/b/a Superior Physical Medicine, and Precision Spine and Pain Management—allegedly billed the application of two pain management devices, ANSiStim and STIVAX, as though they were implantable neurostimulators, when in fact their application was non-surgical and non-invasive. Following a Medicare audit, Superior and Precision self-disclosed improperly billed claims and initiated refund payments to Medicare. USAO WDTXJune 8, 2021
The chiropractor owner and operator of Texas-based Campbell Medical Group PLLC and Johnson Medical Group PLLC d/b/a Campbell Medical Clinic has agreed to pay $2.6 million to settle claims that she and the entities defrauded Medicare and TRICARE. As part of the settlement, Suhyun An and her medical entities will be excluded from participating in federal healthcare programs for ten years. Ms. An and the medical entities allegedly improperly obtained over $3.9 million in reimbursement for unbillable implantations of neurostimulator electrodes. USAO SDTXMay 26, 2021
HEAG Pain Management Center, P.A. (HEAG) and its owner, Dr. Kwadwo Gyarteng-Dakwa (Dr. Dakwa), have agreed to pay $500,000 to settle allegations of defrauding Medicare and Medicaid. According to the government, the defendants knowingly submitted or caused the submission of claims for medically unnecessary diagnostic testing between 2011 and 2016. AG NC; USAO MDNCMay 21, 2021
SavaSeniorCare LLC and related entities (“Sava”) will pay $11.2 million, plus potentially more pursuant to an “ability-to-pay” settlement, to resolve allegations that Sava violated the False Claims Act by causing its skilled nursing facilities to bill Medicare for rehabilitation therapy services that were not reasonable, necessary, or skilled, and that Sava billed the Medicare and Medicaid programs for grossly substandard (i.e., “worthless”) skilled nursing services. The settlement stems from four separate qui tam complaints filed by whistleblowers Rita Hayward, Trammel Kukoyi, Terrence Scott, James Thornton, and Barbara Roberts, who will share an undisclosed portion of the government’s recovery. In 2015, the United States intervened in the litigation and filed a consolidated False Claims Act complaint, alleging inter alia that Sava had exerted significant pressure on its skilled nursing facilities to meet unrealistic corporate targets for the highest Medicare reimbursement rates without regard to patients’ actual clinical needs, and improperly delayed the discharge of patients from its facilities in order to increase billings. Sava will enter into a five-year Corporate Integrity Agreement as part of the settlement. DOJCatch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation
Posted 05/7/21
