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DOJ Catch of the Week - National Pain Care, Inc.

Posted  February 3, 2017

By the C|C Whistleblower Lawyer Team

This week’s Department of Justice “Catch of the Week” goes to pain management physician Dr. Robert Windsor, owner of National Pain Care, Inc. which owns pain management clinics in Georgia and Kentucky. Yesterday, Dr. Windsor agreed to the entry of a $20 million consent judgment to resolve allegations he violated the False Claims Act by billing federal health care programs for surgical monitoring services he did not perform and for medically unnecessary diagnostic tests. See DOJ Pres Release.

According to the government, Dr. Windsor caused the submission of false claims to Medicare and other federal healthcare programs for the monitoring of surgeries that neither he nor any other physician personally monitored but that he represented had been monitored by him. The government further alleged Dr. Windsor submitted false claims for medically unnecessary balance tests, nerve conduction and electromyography procedures, and qualitative drug screens.

In order to satisfy the $20 million consent judgment, Dr. Windsor will sell all but one of his residential and commercial properties and pay the net sale proceeds to the government. Dr. Windsor will also sell certain other assets, including two boats and four jet skis, and pay the net sale proceeds to the government. In addition to the monetary payout, Dr. Windsor was also sentenced to three years, two months in federal prison.

In announcing the settlement, the government stressed how Dr. Windsor “put his own interests above the health and safety of his patients.” He did this by (i) “claiming that he was monitoring the neurological health of patients during surgery when he actually had an unqualified medical assistant do the work,” and (ii) “[p]roviding medically unnecessary services to a vulnerable population, such as Medicare beneficiaries.”  The government made it clear that with the settlement it was hoping to “send a message to others who profit from schemes abusing patient safety that we will pursue justice for our beneficiaries and the programs.”

The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by Kris Frankenberg, Stephanie Herder and Bradley Davis.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government’s recovery.

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