Related Federal Cases
- SNAP Fraudster Busted · Rhode Island
- Marlene Barkheimer, FDIC Advisory Committee Appointment, Washington… · Louisiana
- Letitia James Secures Preliminary Injunction Against Trump Administ… · Arizona
- Letitia James, Revocation of Temporary Protected Status, New York, … · California
- Letitia James, Dismantling AmeriCorps Funding, New York NY, 2023 · Arizona
Nevada Doc Busted for Bilking Medicare
BOSTON – In a brazen scheme to line his pockets, Nevada Advanced Pain Specialists, a Reno-based medical practice, has agreed to pay a hefty $1 million to resolve allegations of submitting false claims for medically unnecessary urine drug testing (UDT) to Medicare.
Pursuant to the settlement agreement, NAPS admits that it ordered confirmatory UDT – testing designed to confirm the results of presumptive UDT – despite failing to first obtain presumptive UDT results. In fact, NAPS did not consult the presumptive UDT results before ordering their confirmation but continued to perform presumptive tests in-house and bill Medicare as if they were medically necessary.
“NAPS ordered presumptive testing in order to collect more from Medicare, not because the tests were medically necessary,” said Acting U.S. Attorney Nathaniel R. Mendell. “It’s not supposed to work that way, of course. NAPS was improperly draining resources from an important federal program, and we commend it for resolving the matter expeditiously.”
According to authorities, the scam was orchestrated by NAPS, which failed to follow Medicare rules and billed improperly for unnecessary tests. “Healthcare providers are expected to closely follow Medicare rules and bill properly — nothing more, nothing less,” said Special Agent in Charge Phillip M. Coyne of the U.S. Department of Health and Human Services, Office of Inspector General. “When that obligation is violated, government health care programs – and American taxpayers – pay the price. We are committed to pursuing these types of allegations along with our law enforcement partners as we work to protect the integrity of our federal healthcare system.”
“Public health insurance programs, such as Medicare, incur staggering financial losses when their programs are exploited. Today’s settlement should make it perfectly clear that those who bill for medically unnecessary tests will be held accountable,” said Joseph R. Bonavolonta, Special Agent in Charge of the Federal Bureau of Investigation, Boston Division.
Under the qui tam provisions of the False Claims Act, a whistleblower had filed a lawsuit against NAPS, and the relator will receive $150,000 of the recovery. This is a stark reminder that those who abuse the system will be brought to justice and held accountable for their actions.
Assistant U.S. Attorneys Abraham R. George and Charles B. Weinograd handled the matter, with assistance from the Department of Veterans Affairs. This case highlights the importance of maintaining the integrity of our federal healthcare system and protecting it from those who would seek to exploit it for personal gain.
Key Facts
- State: Massachusetts
- Category: White Collar Crime|Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
ðŸâ€Â’ Get the grimiest stories delivered weekly. Subscribe free →
