Owner And Two Managers Of Health Care Practice Agree To Pay $900,000 To Resolve Allegations Of Medically Unnecessary Testing
CHARLOTTE, N.C. - U.S. Attorney Andrew Murray announced today that two former managers and the owner of the now defunct North-Carolina based Carolina Comprehensive Health Network, PA (CCHN) have agreed to resolve allegations that they violated the False Claims Act by causing CCHN to bill claims for medically unnecessary diagnostic tests and procedures to the Medicare and Medicaid programs.
Michael Smith, Codey Brown, and CCHN’s former owner, Dr. Harrison Frank, have collectively agreed to pay $900,000.00 to resolve the allegations.
“When health care professionals engage in deceptive schemes for the sake of their bottom line, their patients’ health is no longer their first priority,” said U.S. Attorney Murray. “Billing Medicare and Medicaid for unnecessary testing wastes taxpayer dollars and diverts funds intended for needed medical care. Working with our state partners, we will use all resources and tools at our disposal to pursue and hold accountable individuals who perpetrate fraud on federal health care programs.”
“When health care programs and providers cheat the Medicaid program, they’re cheating taxpayers,” said Attorney General Josh Stein. “My office will hold accountable any business and individual that commits fraud and wastes health care resources.”
Before it ceased operations, CCHN consisted of a group of healthcare practices, including multiple locations in the Western District of North Carolina, that provided family medicine, immediate care, and pain management services. The settlement resolves allegations that from May 1, 2015 through November 30, 2015, CCHN billed the Medicare and Medicaid programs for unnecessary diagnostic procedures including positional nystagmus testing, rotational axis testing, nerve conduction testing, and autonomous nervous system testing.
The allegations arose from a lawsuit filed by a whistleblower under the qui tam provisions of the federal False Claims Act, and the North Carolina False Claims Act. Under the False Claims Acts, private citizens can bring suit on behalf of the government for false claims and share in any recovery. The act also allows the government to intervene and take over the action. The government conducted the investigation and intervened in this action to effectuate the settlement.
The settlement is a result of the coordinated effort between the Department of Health and Human Services Office of the Inspector General, the North Carolina Attorney General’s Medicaid Investigations Division, and the United States Attorney’s Office for the Western District of North Carolina.
The lawsuit resolved by this settlement is United States and the State of North Carolina ex rel. David A. Majure, M.D., Carla C. Majure v. Carolina Comprehensive Health Network, PA, et al. (5:15-CV-134). The claims resolved in this settlement are allegations only and there has been no determination of liability.