On 1st May 2020, United States Attorney Matthew D. Krueger announced that CPM (Center for Pain Management, S.C.), and its proprietor, Dr. Nosheen Hassan, accepted to remit at least 1.35 million USD settle claims that they collected kickbacks from a urine medication examination lab in trade for ordering medically unrequired exams for Medicaid and Medicare patients. Dr. Hassan and CPM also accepted future contingent remittances for the following 5 years, with the total based on specified monetary criteria. Dr. Hassan and CPM individually signed an Integrity Agreement with HHS-OIG (Department of Health and Human Services -Office of Inspector General) to examine the continuing compliance with applicable Medicaid and Medicare regulations.
CPM ran pain management practices in the Milwaukee metropolitan region. Dr. Hassan was the sole proprietor of CPM and rendered pain management services via CPM. As purported in the Complaint-in-Intervention filed by the United States in the lawsuit, Dr. Hassan and CPM accepted illicit compensation from Midwest (Midwest Laboratory Sales & Consulting, LLC), and its proprietor Matthew Samuelson, in trade for ordering urine exams conducted in the Midwest, in breach of the False Claim Act and the Anti-Kickback Statute.
The government further claimed that Dr. Hassan and CPM ordered these exams despite being aware that they were not medically required. During the course of 5 years over a 5-year-long plan, Dr. Hassan and CPM ordered thousands of unrequired exams that were remitted for by Medicaid and Medicare and collected more than one million USD in illicit kickbacks from Midwest for ordering the exams. The government earlier settled its allegations against Mr. Samuelson and Midwest, who confessed that they breached the Anti-Kickback Statute and False Claim Act.
United States Attorney Matthew D. Krueger said that Medicaid and Medicare only remitted for exams that were required by the patients, not exams ordered by doctors to fill their coffers. He added that as pain management experts prescribing controlled medications, Dr. Hassan and CPM exploited the government and their patients to order thousands of unrequired medical examinations in exchange for illicit remittances from a lab. He further added that the resolution bore a significant penalty on Dr. Hassan and CPM, and it assisted the federal government whole for their offenses.
Special Agent in Charge of HHS-OIG Chicago Region, Lamont Pugh III, said that the watchdog agency would hold liable health care providers who attempted to maximize their gains by accepting kickbacks to charge health care systems for medically unrequired exams. He added that his office would closely observe Dr. Hassan and CPM under the terms of an Integrity Agreement to assist in ensuring legal charging in the future.
Special Agent in Charge of Federal Bureau of Investigation Milwaukee Field Office, Robert Hughes, said that the FBI prioritized attempts to eliminate fraud and would proceed to hold liable doctors who abused Medicaid and Medicare finances. He added that by necessitating Dr. Hassan and CPM to reimburse more than one million USD, the resolution emphasized that health care providers could not put their welfare ahead of the citizens or their patients.
The government’s complaint was as a consequence of a whistleblower lawsuit filed under qui tam provisions of the False Claims Act. Accordingly, the whistleblower would acquire a share of the resolution. The complaint is titled United States ex rel. Fering v. Center for Pain Management, et al., 17-cv-1796, and is ongoing in the District Court for the Eastern District of Wisconsin.
The investigation for the case was conducted by the Drug Enforcement Administration, the HHS-OIG, and the FBI. The United States was represented by the United States Assistant Attorneys Lisa Yun and Michael Carter in this case. The resolution settlement stated that claims only; Dr. Hassan and CPM did not admit guilt for the claims.
You risk a severe imprisonment sentence and hefty fines if found guilty of breaching the False Claim Statute, Anti-Kickback Statute, or the Controlled Substance Act. Plotting to commit health care fraud by swindling state-sponsored programs such as TRICARE or Medicaid could also have you locked up in the big house as fast. Individuals accused of committing the above crimes are treated as lawbreakers, and they can face severe punishment when and if found guilty. When charged with any health care fraud-related offenses, seeking the services of an excellent and experienced legal team is a matter of when not if.
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