Kansas Clinic Agrees to Pay $775,000 To Resolve False Claims Act Allegations
KANSAS CITY, KAN. - Trina Health–Wichita NW, LLC, located in Wichita, Kan., and Jack West of Dallas, Texas, one of the company’s principals, agreed to pay the United States $775,000 to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare and TRICARE.
The company submitted claims to the federal programs for what the company called “artificial pancreas treatment” for diabetes. The United States alleged that from September 2015 through May 2017, Trina and West violated the False Claims Act because the claims were actually for an outpatient insulin infusion regimen that was not medically reasonable or necessary and specifically not covered by the federal programs.
Medicare is a federal health insurance program for people 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. TRICARE, formerly known as CHAMPUS, is a federal health care system administered through the Department of Defense for uniformed service members, retirees, and their families.
“This office is committed to civil health care fraud enforcement as a key component of the mission of our office,” said United States Attorney Stephen McAllister. “Medicare beneficiaries rightly expect medically appropriate treatment. We will continue working with our law enforcement partners to hold accountable those who defraud federal programs and taxpayers.”
“Medicare enrollees, as well as taxpayers, deserve nothing less than appropriate medical treatments,” said Curt L. Muller, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “Those claiming government health program funds for medically unnecessary services should expect aggressive investigation and legal action.”
“I applaud the Department of Justice and the U.S. Attorney for the District of Kansas for their continued efforts to hold health care providers accountable to the American taxpayer,” said Army Lt. Gen. Ronald Place, director of the Defense Health Agency. “The efforts of the Department of Justice to safeguard the health care benefit for our service members, veterans and their families is commendable. The Defense Health Agency continues to work closely with the Justice Department, and other state and federal agencies to investigate all those who participated in fraudulent practices.”
The investigation was conducted by the United States Department of Health and Human Services, Office of Inspector General, Office of Investigations, the United States Attorney’s Office for the District of Kansas, and the Defense Criminal Investigative Service. The matter was handled by Assistant United States Attorney Jon Fleenor.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.