Modernizing Medicine Agrees to Pay $45 Million to Resolve Allegations of Accepting and Paying Illegal Kickbacks and Caused False Claims
The United States Attorney’s Office for the District of Vermont announced today that physician Lynn E. Madsen, M.D., of Townshend, Vermont, has paid $76,000 to the United States to resolve allegations that she violated the federal False Claims Act, 31 U.S.C. § 3729, by knowingly presenting, or causing to be presented, false claims for payment to Medicare and Medicaid. The money will be divided between the federal Medicare, federal Medicaid, and Vermont Medicaid programs to which Dr. Madsen submitted the alleged false claims.
The United States contends that, from on or about November 1, 2013, to November 30, 2015, Dr. Madsen knowingly presented, or caused to be presented, hundreds of false claims for payment to the Medicare and Medicaid programs for trigger point injections (a pain management procedure) that were not reasonable and medically necessary and which did not comply with applicable Medicare and Medicaid laws, regulations, and program limitations. More specifically, the United States contends that the trigger point injections performed by Dr. Madsen consisted solely of saline or saline-based anthroposophic injectates that were devoid of any approved therapeutic agent and not considered reasonable and medically necessary under applicable Medicare and Medicaid laws, regulations, and program limitations.
The settlement announced today resolves the foregoing allegations without the need for litigation. Pursuant to the terms of the settlement agreement, the agreement and payment are neither an admission of liability by Dr. Madsen, nor a concession by the United States that its claims were not well founded.
This matter was investigated by the United States Attorney’s Office for the District of Vermont and the Office of the Inspector General of the Department of Health and Human Services, with assistance from the Medicaid Fraud and Residential Abuse Unit of the Vermont Attorney General’s Office. Assistant United States Attorney Ben Weathers-Lowin handled the matter on behalf of the United States. Dr. Madsen was represented by Ian P. Carleton of the law firm Sheehey, Furlong & Behm, P.C.