The United States has filed a complaint in intervention, accusing Clarksville Pain Institute, LLC, Pain Institute of Nashville, PLC, Michael Cox, and Debbie Cox of violating the False Claims Act. Acting U.S. Attorney Thomas J. Jaworski for the Middle District of Tennessee made the announcement. The complaint also involves common law claims of unjust enrichment and payment by mistake.
According to the 70-page complaint, since at least 2014, these pain clinics and the Coxes allegedly submitted false claims for diagnostic testing services that were not medically necessary, including urine drug screens, allergy tests, and psychological tests.
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The complaint states that staff at the Clarksville pain management clinic were pressured to bill for more tests than medically necessary. The clinic reportedly conducted routine urine tests without reviewing the results and operated multiple schemes to profit from various diagnostic tests. Additionally, the defendants allegedly ignored multiple warnings from consultants, auditors, and insurers regarding their non-compliance with Medicare requirements. Patients reportedly described feeling like they were treated like cattle, receiving unnecessary tests to obtain their pain medications.
The government’s investigation was prompted by a lawsuit filed under the qui tam provisions of the False Claims Act, which allows private parties to file actions on behalf of the United States and potentially receive a portion of any recovery.
The investigation is being conducted by the Department of Health and Human Services, Office of Inspector General, and the Department of Veterans Affairs, Office of Inspector General. Assistant U.S. Attorney Michael Tackeff is representing the United States.
It is important to note that the claims made by the United States are currently allegations, and no determination of liability has been made. The lawsuit is titled United States ex. rel. Krista Nicholson, et al. v. Clarksville Pain Institute, LLC, et al., Case No. 3:20-cv-00309 (M.D. Tenn.).
Source: Read Original Release
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