Lexington Therapy Practice Agrees to Pay $200,000 to Resolve Allegations That It Submitted False Claims to Medicare and Medicaid

COLUMBIA, South Carolina ---- United States Attorney Sherri A. Lydon announced today that Vital Energy Occupational Therapy and Wellness Center, LLC, headquartered in Lexington, South Carolina, has agreed to pay $200,000 to resolve allegations that it knowingly submitted false or fraudulent claims to Medicare and Medicaid for physical and occupational therapy services.     

The settlement announced today resolves allegations that Vital Energy violated federal law from November 1, 2013, through April 30, 2016, by submitting bills for individual therapy services when group therapy services were actually provided, and by submitting bills for therapy services using former employees’ names and billing numbers when those former employees did not actually provide the therapy services.  Vital Energy denies these allegations.

The allegations resolved by the settlement were brought in a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act.  The Act permits private parties to sue on behalf of the government when they believe that defendants submitted false claims for government funds and to share in any recovery.  As part of today’s resolution, the whistleblower will receive $36,000. 

“The False Claims Act exists to protect taxpayer dollars from waste, fraud, and abuse,” said U.S. Attorney Lydon.  “And when health care providers fail to follow the rules, the public bears the cost.  It is through settlements like these that we recover those costs and discourage fraudulent and reckless billing.”

The settlement was the result of an investigation by the United States Attorney’s Office, with support from the Department of Health and Human Services and the South Carolina Attorney General’s Office Medicaid Fraud Control Unit.  The settlement was handled by Assistant United States Attorney Brook B. Andrews of the Columbia office. 

The case is captioned United States ex rel. Ashley C. Baggett, DPT v. Vital Energy Occupational Therapy and Wellness Center, LLC, d/b/a Vital Energy Wellness and Rehab Center, Case No. 3:16-cv-1692-DCC (D.S.C.).  The claims resolved by the settlement are allegations only, and there has been no determination of liability. 

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