UNITED STATES REACHES $37 MILLION SETTLEMENT OF FRAUD LAWSUIT AGAINST CIGNA FOR SUBMITTING FALSE AND INVALID DIAGNOSIS CODES TO ARTIFICIALLY INFLATE ITS MEDICARE ADVANTAGE PAYMENTS
NASHVILLE – United States Attorney Henry C. Leventis for the Middle District of Tennessee announced today that Affinity Acupuncture, LLC (“Affinity”) has agreed to pay the United States $250,000 to resolve allegations that it violated the False Claims Act (“FCA”).
The United States contends that Affinity violated the FCA by submitting false claims to the U.S. Department of Veterans Affairs (“VA”) for non-reimbursable acupuncture for which the claims were not authorized, not allowed as coded, or lacked supporting documentation. The settlement covers conduct for the period from January 2015 through December 2020, during which the VA reimbursed Affinity for claims arising from its false statements.
“The VA audit revealed that millions of dollars were improperly paid to non-VA acupuncture providers around the country for procedures that were not authorized, not allowed as coded, or lacked supporting documentation,” said United States Attorney Henry C. Leventis. “This settlement is in keeping with our commitment to working with the VA and its Office of Inspector General to identify, and, whenever possible, recover improper payments.”
This investigation follows an internal audit by the VA’s Office of Inspector General and its published report issued in December 2021 that found that the VA made an estimated $137 million in improper payments for acupuncture nationwide during Fiscal Years 2018 and 2019.
“VA’s Community Care programs provide veterans and their families the ability to obtain critical healthcare services locally,” said Special Agent in Charge Kim R. Lampkins of the Department of Veterans Affairs Office of Inspector General’s Mid-Atlantic Field Office. “Today’s civil settlement demonstrates the VA OIG’s ongoing efforts to protect the integrity of VA’s programs and services.”
The civil claims resolved by this settlement are allegations. There has been no determination or admission of liability in this matter.
This case was investigated by the VA-Office of Inspector General. Assistant U.S. Attorney Mike Tackeff represented the United States.
# # # # #
Mark H. Wildasin
Executive Assistant U.S. Attorney