Pain Management Clinics Settle Medicare Civil Fraud Claims
RICHMOND, Va. – National Spine and Pain Centers (NSPC), and Physical Medicine Associates (PMA), with pain management clinics in northern Virginia, Glen Allen and Fredericksburg, have agreed to pay approximately $3.3 million to settle civil fraud allegations.
The settlement resolves civil fraud allegations that defendants billed Medicare and other federal healthcare providers for medical services performed by physician assistants and nurse practitioners as if physicians had provided the services, submitted claims for urine drug tests in violation of the Stark Law and/or the Anti-Kickback Statute, and ordered medically unnecessary urine drug tests.
The settlement resolves a lawsuit filed in the U.S. District Court for the Eastern District of Virginia by a former PMA physician assistant under the qui tam, or whistleblower, provisions of the False Claims Act. Under the False Claims Act, private citizens, also known as relators, can bring a suit on behalf of the United States and share in any recovery. Under the False Claims Act, relators are awarded 15 to 25 percent of the proceeds of the settlement amount depending on the extent to which the relator substantially contributed to the recovery.
The resolutions obtained in this matter were the result of a coordinated effort between the U.S. Attorney’s Office for the Eastern District of Virginia, the Department of Health and Human Services Office of Inspector General, the U.S. Office of Personnel Management Office of the Inspector General, and the Defense Criminal Investigative Service Office of Inspector General.
The matter was investigated by Assistant U.S. Attorney Robert McIntosh. The civil claims settled by this False Claims Act agreement are allegations only; there has been no determination of civil liability.
A copy of this press release may be found on the website of the U.S. Attorney’s Office for the Eastern District of Virginia.