Tennessee Doctor Pays More than $1 million to Settle Alleged Violations of the False Claims Act
America has long been diagnosed with an opioid problem. This problem is exacerbated by physicians who inappropriately prescribe these painkillers to their patients. Thus, the Justice Department announced last week that a Tennessee-area chiropractor has paid $1.45 million, plus interest, to resolve allegations of False Claims Act violations. The settlement also calls for a pain clinic nurse practitioner to surrender her DEA registration and pay $32,000 because she allegedly violated the Controlled Substances Act. Four pain clinics managed by Matthew Anderson and his company PMC LLC – Cookeville Center for Pain Management; Spinal Pain Solutions in Harriman; Preferred Pain Center of Grundy County in Gruetli Laager; and McMinnville Pain Relief Center – are now closed as a result of this matter.
The medications Anderson is accused of having improperly billed Medicare include painkilling Opioids. “More Americans are dying because of drugs today than ever before—a trend that is being driven by opioids,” said Attorney General Jeff Sessions. “If we’re going to end this unprecedented drug crisis, which is claiming the lives of 64,000 Americans each year, doctors must stop overprescribing opioids and law enforcement must aggressively pursue those medical professionals who act in their own financial interests, at the expense of their patients’ best interests. Today’s settlement is a positive step that will help save lives, as well as protect taxpayers’ money, in Tennessee and across the United States.”
The government claims that from 2011 through 2014, Anderson and PMC encouraged pharmacies to submit requests for Medicare for pain killers including opioids for no legitimate medical purpose. The medications were written at the Cookeville Center for Pain Management. The government also contends that Anderson caused all four of his clinics to bill Medicare for office visits that were not reimbursable at the levels he claimed they should be. Finally, the government claims that Anderson and PMC caused the submission of Medicare claims by two nurse practitioners who were not participating with a physician as required by Tennessee law.
Under the terms of the settlement agreement, Anderson and PMC paid $1.45 million, plus interest. The government will receive the lion share of that amount while the state of State of Tennessee will receive more than $150,000. Anderson and PMC have also been excluded from billing federal health care programs for five years. Lastly, three of the clinics Anderson was involved with will forfeit $53,840 and have their bank accounts seized by the United States. A second part of the settlement agreement requires that Cindy Scott, a nurse practitioner from Nashville, to pay $32,000 to the government and to surrender her DEA registration until October of 2021.
The United States and Tennessee initiated their investigation of this matter after a former office manager for the Cookeville Center for Pain Management filed a qui tam lawsuit against Anderson, et al. The qui tam, or whistleblower, provisions of the False Claim Act allows private citizens – with or without a qui tam attorney – to sue on behalf of the government and to share in any recovery. The whistleblower will receive $246,500 under the settlement.
