Richmond, Va. – In a major blow to billing irregularities in the healthcare sector, National Spine and Pain Centers (NSPC) and Physical Medicine Associates (PMA), operators of pain management clinics in northern Virginia, have agreed to fork over approximately $3.3 million to settle civil fraud allegations.
The settlement stems from allegations that NSPC and PMA billed Medicare and other federal healthcare providers for services performed by physician assistants and nurse practitioners as if physicians had provided them, a clear violation of billing standards. Additionally, the clinics were accused of submitting claims for urine drug tests in violation of the Stark Law and/or the Anti-Kickback Statute, and conducting unnecessary urine drug tests.
This settlement was reached following a lawsuit filed in the U.S. District Court for the Eastern District of Virginia by a former PMA physician assistant under the qui tam provisions of the False Claims Act. The False Claims Act allows private citizens, or relators, to sue on behalf of the United States and receive a portion of any recovery. In this case, the relator is entitled to 15 to 25 percent of the settlement amount for their substantial contribution to the recovery.
The resolution of this matter involved a coordinated effort between the U.S. Attorney’s Office for the Eastern District of Virginia, the Department of Health and Human Services Office of Inspector General, the U.S. Office of Personnel Management Office of the Inspector General, and the Defense Criminal Investigative Service Office of Inspector General.
Assistant U.S. Attorney Robert McIntosh led the investigation into these allegations. It is important to note that the civil claims settled by this False Claims Act agreement are mere allegations; there has been no determination of civil liability in the case.
A copy of this press release can be found on the website of the U.S. Attorney’s Office for the Eastern District of Virginia.
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Key Facts
- State: Virginia
- Agency: DOJ USAO
- Category: Fraud & Financial Crimes
- Source: Official Source ↗
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