New York City, NY, Jan. 12, 2022 — A group of pain management clinics and surgery centers in New Jersey and New York City and their physician owner have agreed to pay the government $7.4 million to settle a whistleblower lawsuit filed by Phillips & Cohen LLP that alleged Medicare billing fraud involving P-Stims and other electro-acupuncture devices.
The “qui tam” (whistleblower) case, which the US Department of Justice joined, alleged that Dr. Amit Poonia and his pain management clinics and surgery centers violated the False Claims Act by submitting false claims to Medicare for the implantation of “P-Stims” (percutaneously placed microchip-controlled pulsed neurotransmitters) and “NSS” (Neuro-Stim System) devices to treat pain.
“P-Stims and neuro-stim system treatments are considered acupuncture under Medicare guidelines,” said Emily Stabile, a whistleblower attorney at Phillips & Cohen. “With few exceptions, Medicare does not allow billing for acupuncture procedures nor for certain electro-acupuncture devices, such as P-Stims and neuro-stim system procedures.”
Two former employees of the pain management clinics, Lakshmi Anu Doddapaneni and Christian Reyes, were the whistleblowers in the qui tam case. Phillips & Cohen filed the qui tam complaint in 2018 “under seal” (meaning it wasn’t publicly available) in federal district court in Brooklyn, NY.
“Our clients were very concerned about the high number of procedures that the clinics were recommending and performing,” said Colette Matzzie, a whistleblower attorney and partner at Phillips & Cohen. “Ms. Doddapaneni and Mr. Reyes cared a great deal about the patients, many of whom suffer from chronic pain.”
DOJ investigated the whistleblowers’ complaint and joined some of the allegations, which are covered in the settlement agreement. The case was made public today when the seal was lifted and the US Attorney’s Office for the Eastern District of New York announced the settlement.
The settlement amount includes Medicare overpayments that the defendants received from 2012 to 2017 and fines paid to settle the false claims allegations.
“We greatly appreciate the efforts by our attorneys, Colette Matzzie and Emily Stabile, and the government to investigate and pursue this case,” said Ms. Doddapaneni and Mr. Reyes in a joint statement.
In particular, the whistleblowers and their attorneys thanked Assistant US Attorney Jolie Apicella and Investigative Auditor Joseph Giambalvo, both of the Eastern District of New York.
Pain management clinics and their practices have been a government enforcement target recently for providing unnecessary medical treatment, Medicare billing fraud for P-Stims and other electro-acupuncture devices, illegal kickbacks and other issues.
In September, the government won a default judgment of $140 million against some South Carolina pain management clinics and drug testing labs owned by a chiropractor in a case alleging the pain management clinics billed Medicare for medically unnecessary injections and prescriptions, including opioid prescriptions. Earlier in the year, two pain management clinics in Florida paid the government $1.6 million to settle charges that they had engaged in an illegal kickback scheme to induce patients to receive injection procedures and improperly charged Medicare for other services.
Last year, a neurosurgeon and his practice paid the government over $1 million to settle claims that included allegations of improper billing for the implantation of P-Stim devices.
The False Claims Act allows whistleblowers to sue individuals and entities that are defrauding the federal government and recover funds on the government’s behalf. The law offers whistleblowers protection against job retaliation and rewards based on the amount defendants pay to settle the false claims allegations. Learn more about qui tam cases.
The entities owned by Dr. Poonia that are part of the settlement are: New Jersey Interventional Pain Management Center P.C. in East Brunswick, New Jersey; New York Interventional Pain Management P.C. in Edison, New Jersey; Advanced Interventional Pain Management Center LLC in Edison, New Jersey; Interventional Pain Management & Ortho Spine Center LLC in Edison, New Jersey; Interventional Pain Management Center P.C. in Brooklyn, New York; Advanced Multispecialty Group in Edison New Jersey; Central Jersey Pain Institute LLC in East Brunswick, New Jersey; Global Anesthesia Group LLC in Edison, New Jersey; Park Avenue Surgery Center LLC in Edison, New Jersey; Springfield Surgery Center LLC in Springfield, New Jersey; Endo Surgi Center of Old Bridge LLC in Old Bridge, NJ; Main Avenue Clifton Surgery Center LLC in Edison, New Jersey; Premium Interventional Pain Management in Edison, New Jersey; Synergy Medical Laboratories Inc. in Old Bridge, New Jersey; and Universal Transportation Service LLC in New Jersey.
Settlement agreement with Dr. Amit Poonia and other defendants.
Settlement agreement with Endo Surgi Center of Old Bridge LLC.
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