Ada, Oklahoma Podiatrist Agrees To Pay $7,000,000.00 To Resolve False Claims Act Allegations

MUSKOGEE, OKLAHOMA - The United States Attorney’s Office for the Eastern District of Oklahoma announced today that Dr. Bryan Andrew Blanck, a Doctor of Podiatric Medicine (DPM) who formerly owned and operated the Valley View Foot and Ankle Center, located in Ada, Oklahoma, has agreed to pay $7,000,000.00 to the United States to resolve allegations he violated provisions of the False Claims Act (FCA).

The settlement resolves allegations that Dr. Blanck submitted false claims to the VA Choice/Patient-Centered Community Care programs for excessive medical services and for higher levels of service than what were medically reasonable or necessary for veterans receiving bioengineered skin substitutes and skin substitute related treatment.

The Department of Veterans Affairs, Veterans Health Administration (VHA), provides integrated health care to U.S. Military Veterans in the United States through VA Medical Centers and VA Outpatient Clinics. VHA provides health care services similar to traditional hospitals.  Veterans enrolled in VA health care have the option to receive care at the VA or at health care facilities within the local community. TriWest oversees the scheduling, claims processing and billing functions for veterans receiving care in the community. Dr. Blanck accepted and treated veterans at the Valley View Foot and Ankle Clinic.

An audit conducted by the VA revealed that from February 14, 2017 – June 14, 2018, Dr. Blanck was the #1 billing podiatrist out of 4,014 podiatrists nationwide in VA Choice and accounted for 23.7% of total podiatrist billings in the VA Choice program. During the same time period, Dr. Blanck was the #1 billing provider out of 280,073 individual providers in the entire VA Choice program across the nation. These high billing numbers sparked an investigation by the VA-Office of Inspector General. Based on the investigation, it was alleged Dr. Blanck misrepresented the seriousness of patients’ wounds to Tri-West in order to obtain authorization to administer bioengineered skin substitutes and copy and pasted medical notes as justification for his billing. For skin substitutes to be used, a detailed treatment history is required of standard wound care for a minimum of four weeks. At the end of the minimum four weeks, documentation must be shown as to why standard wound care has failed and it is necessary to use skin substitutes. It was alleged Dr. Blanck regularly administered skin substitutes without performing standard preliminary wound care and billed the VA Choice program for these medically unnecessary services.

“Protecting the citizens of our district against unscrupulous health care providers who do not play by the rules is a priority for my office,” said United States Attorney Christopher J. Wilson. “Billing for and receiving payment for medically unnecessary and inappropriate levels of care is wrong and a waste of taxpayer dollars. The False Claims Act is a valuable weapon in the government’s arsenal to combat these types of abuses.”

“Subjecting veterans to unnecessary medical procedures at the expense of the taxpayer cannot be tolerated. Such activities put at risk VA’s ability to provide timely, quality health care within the local community,” said Special Agent in Charge Kris Raper with the Department of Veterans Affairs Office of the Inspector General’s South Central Field Office. “The VA OIG will continue to work with our law enforcement partners to ensure the integrity of VA’s programs and services.”

This civil settlement illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $26.7 billion through False Claims Act cases, with more than $16.8 billion of that amount recovered in cases involving fraud against federal health care programs.

This case was a coordinated effort among the United States Attorney’s Office for the Eastern District of Oklahoma and the Office of the Inspector General of Veteran Affairs. The lawsuit is captioned United States v. Bryan Blanck, Case No. 6:23-cv-00003-JAR (E.D. Okla.).

Assistant United States Attorneys Michael O'Malley and Clay Compton represented the United States.

The claims settled or pursued by the government are only allegations; there has been no determination of liability.