Virginia pain management clinics agree to pay $3.3M to settle civil fraud claims

Medical justice
A company that operates pain management clinics in Virginia agreed to settle claims brought against it for approximately $3.3 million. (Getty/yavdat)

A company that operates several pain management practices in Virginia agreed to pay approximately $3.3 million to settle civil fraud allegations.

National Spine and Pain Centers and Physical Medicine Associates, which operates pain management clinics in northern Virginia, Glen Allen and Fredericksburg, agreed to the settlement Thursday, according to the U.S. Attorney’s Office for the Eastern District of Virginia.

The settlement resolves civil fraud allegations that the clinics billed Medicare and other federal healthcare providers for medical services performed by physician assistants and nurse practitioners as if physicians had provided the services, submitted claims for urine drug tests in violation of the Stark Law and/or the Anti-Kickback Statute and ordered medically unnecessary urine drug tests.

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

The settlement resolves a lawsuit filed by Michelle O’Connor, a physician assistant and former employee at Physical Medicine Associates, under the qui tam or whistleblower provisions of the False Claims Act. She filed the lawsuit in 2015 alleging her former employer overcharged the government for services and ordered unnecessary drug tests.

The clinics were alleged to have overcharged Medicare, TRICARE and the Federal Employees Health Benefits Program, according to the law firm Cohen Milstein Sellers & Toll, which represented O’Connor.

“This settlement illustrates the positive impact that one brave person can have if they step forward when they believe that the government has been cheated and taxpayer dollars wasted,” said Jeanne Markey, a partner at the law firm and co-lead counsel for O’Connor.

RELATED: Uncertainty surrounds healthcare fraud enforcement. Here are some trends to watch in 2019

Charges against 14 other defendants named in the whistleblower’s complaint are being dismissed as part of the settlement agreement, the law firm said.

Whistleblowers are entitled to receive a portion of the proceeds of any settlement or judgment awarded against a defendant.

The civil claims settled by the agreement are allegations only, and there has been no determination of civil liability, according to the U.S. Attorney’s Office.

Suggested Articles

Medicare Part D beneficiaries could see their out-of-pocket costs go up next year before they reach catastrophic coverage, a new analysis shows.

Memorial Sloan Kettering Cancer Center has tapped former CVS Health and Aetna executive Claus Torp Jensen, Ph.D., as its first chief digital officer.

California health officials have released their first report on the price hikes drug companies sought to shield.