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2 former healthcare executives part of $41M billing fraud settlement

A pain clinic and a laboratory in Florida, both subsidiaries of Brentwood, Tenn.-based Surgery Partners, and two former Surgery Partners executives have agreed to pay $41 million to resolve alleged violations of the False Claims Act, according to the Department of Justice.

The settlement resolves allegations that Tampa (Fla.) Pain Relief Center and Logan Laboratories in Tampa billed Medicare and other government healthcare programs for medically unnecessary urine drug testing. Michael T. Doyle, former CEO of Surgery Partners, and Christopher Utz Toepke, former group president of ancillary services at Surgery Partners and former vice president of Tampa Pain, allegedly helped develop and implement a policy that resulted in the claims being submitted, according to the Justice Department.

Prosecutors alleged that the defendants rolled out a policy of automatically ordering both presumptive and definitive urine drug testing for every patient at every visit without a physician determining whether the tests were medically necessary. From January 2010 through December 2017, false claims for medically unnecessary tests were submitted by both Tampa Pain and Logan Laboratories, the government alleged.

In addition to the monetary settlement, Tampa Pain and Logan Laboratories entered into a corporate integrity agreement with HHS' Office of Inspector General.

The allegations resolved by the settlement were originally brought in two lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act.

via Becker's

#OIG #fraud #medicalbilling #DOJ #falseclaimsact

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