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Gulfport, Miss. - A Mississippi physician and his family medical practice have agreed to pay $375,000 to resolve False Claims Act allegations of P-Stim Device Fraud, announced U.S. Attorney Darren J. LaMarca.
Kevin Cooper M.D., and his family medical practice, Cooper Family Medical Center, have agreed to pay $375,000 to resolve allegations that they knowingly and improperly billed Medicare for acupuncture devices in violation of the False Claims Act (“FCA”).
The United States alleges that over a one-year period Dr. Cooper, through Cooper Family Medical Center, billed Medicare over $900,000 for non-reimbursable acupuncture devices that were not surgically implanted despite using billing codes indicating that they were. As set forth in the parties’ settlement agreement, the United States alleges that from July 2018 to August 2019, Dr. Cooper routinely presented, or caused to be presented, false claims to Medicare using CPT Code L8680 (implantable neurostimulator, pulse generator) and/or CPT Code 64555 (implantation of peripheral nerve neurostimulator electrodes, accessed through the skin), and received $179,106.72 from Medicare to which he and his clinic were not entitled.
P-Stim is an electro-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 then provides intermittent stimulation by electrical pulses. It is a single-use, battery-powered device designed to be worn for approximately four days until its battery runs out, at which time the device is thrown away. Medicare does not reimburse for such acupuncture devices, nor did Dr. Cooper perform surgical implantation of these devices as he billed to Medicare. Other brand names for this device include Stivax, NeuroStim, ANSiStim, E-Pulse, and NSS-2 Bridge.
“This office will hold accountable those providers who are improperly paid for non-reimbursable acupuncture under the guise of surgically implanted neurostimulators,” said U.S. Attorney Darren LaMarca.
The FCA claims settled are allegations only, and there has been no determination of liability. This case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General.