PHILADELPHIA, PA – First Assistant United States Attorney Jennifer Arbittier Williams announced that chiropractor Ron Siscoe and his practice, Ovation Center of Integrative Medicine (“Ovation”), have agreed to pay $98,497.62 to resolve liability under the False Claims Act for the alleged improper billing of electro-acupuncture devices called Stivax and/or P-Stim. This is the second electro-acupuncture device settlement announced in this District, as part of a U.S. Attorney’s Office ongoing investigation. (The first involved Dr. Richard Frey and Physicians Alliance Ltd., and was announced on September 17, 2019).
From July 13, 2016 through August 21, 2017, Siscoe and Ovation billed Medicare for the implantation of neurostimulator electrodes, a surgical procedure usually necessitating an operating room for which Medicare reimburses thousands of dollars. However, Siscoe was not conducting that surgery. Instead, a nurse practitioner was applying a Stivax device in an office setting without surgery or anesthesia. In addition, for many of the claims at issue, Siscoe and Ovation billed the procedure using the National Provider Identification number of a physician who did not actually perform or supervise the procedure.
Stivax is an electric acupuncture device that, pursuant to manufacturer’s instructions, is affixed behind a patient’s ear using an adhesive. Needles are inserted into the patient’s ear and affixed using another adhesive. Once activated, the device provides intermittent stimulation by electrical pulses. It is a single-use, battery-powered device designed to be worn for several days until its battery runs out, at which time the device is thrown away. Medicare does not reimburse for acupuncture or for acupuncture devices such as Stivax, nor does Medicare reimburse for it as a neurostimulator or as implantation of neurostimulator electrodes. Other brand names for this device include P-Stim, NeuroStim, ANSiStim, E-Pulse, and NSS-2 Bridge.
On May, 17, 2018, SafeGuard Services LLC, the Northeastern Unified Program Integrity Contractor (“UPIC”) of Medicare, provided Ovation with notice that it was initiating a post-payment medical review of certain of Ovation’s claims for Stivax services. In response, Ovation conceded that the Stivax claims were inappropriate and thus agreed to make voluntary repayment to Medicare for those claims the UPIC had identified.
“We said it in September and say it again now: acupuncture devices may not be billed as surgically implanted neurostimulators,” said First Assistant U.S. Attorney Williams. “Medicare paid thousands of dollars because of the alleged improper billing alleged here, which harms American taxpayers. We appreciate Ovation’s willingness to promptly negotiate a resolution in this matter.”
Williams continued, “We would encourage anyone who may have been involved in P-Stim false billing to come forward voluntarily and self-disclose the misconduct. As this second P-Stim settlement in just the last month shows, we are continuing to work closely with our partners at CMS’s Center for Program Integrity, the Department of Health and Human Services Office of Inspector General, and sister U.S. Attorney’s Offices around the country to hold accountable any other providers who inappropriately billed this device and any product distributors or marketers who may have architected or carried out such a billing scheme.”
“Every dollar saved is critical to the sustainability of our Medicare program and the needs of our beneficiaries,” said Centers for Medicare and Medicaid Services Administrator Seema Verma. “We thank our partners at the Department of Justice and Department of Health and Human Services Office of Inspector General for working hard with us to identify, investigate, and eliminate waste, fraud and abuse in our federal healthcare programs.”
“Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General. “HHS-OIG, CMS’s Center for Program Integrity, and the U.S. Attorney’s Office will continue to evaluate and pursue inaccurate billings of P-Stim and similar devices.”
The settled civil claims are allegations only. There has been no determination of civil liability. This case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General. It was handled by Assistant U.S. Attorney Matthew E. K. Howatt, Civil Chief Gregory B. David, and Auditor Dawn Wiggins.