Kentucky Pain Management Physician Pays $20M to Settle FCA Charges

By the C|C Whistleblower Lawyer Team

Dr. Robert Windsor, the owner of several Kentucky and Georgia pain management clinics operating under the umbrella of National Pain Care, Inc., agreed to a $20 million consent judgment resolving government allegations he billed federal health care programs for surgical monitoring services he did not perform, and for medically unnecessary diagnostic tests. To satisfy the judgment, Windsor will have to sell several properties, two boats, and four jet skis.

The government alleged Windsor participated in two schemes. First, from approximately 2008 to 2013, Windsor submitted claims to Medicare, TRICARE, and Federal Employees Health Benefits Program for online, real-time, intraoperative monitoring of surgeries that Windsor did not in fact monitor, but instead left to the supervision of an unqualified physician’s assistant. Windsor is currently serving a 38 month prison sentence related to this conduct. Second, from 2010 to 2014, Windsor submitted claims to the same programs, as well as to Kentucky and Georgia Medicaid, for medically unnecessary balance tests, nerve conduction and electromyography procedures, and qualitative drug screens.

The consent judgment is a result of two lawsuits brought by three whistleblowers under the qui tam provisions of the False Claims Act. Relator’s shares have yet to be determined.

Tagged in: FCA Federal, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Other Government Health Programs,