Gregory Thomas White Jr, DC and Healing Place Medical, PC agreed to pay $170,000 to resolve liability under the False Claims Act for the alleged improper billing of “Sanexas” devices. This settlement is the latest action in the national investigation into the improper billing involving the RST Sanexas neoGEN-Series device. White is a chiropractor and owner of the Healing Place. The United States contends that Healing Place submitted approximately 27,121 claims to Medicare for payment under various codes for Sanexas treatment and vitamin injections, TM Flow testing, and ENFD testing, during the relevant time period, all of which were non-reimbursable.
The United States contends that Medicare did not permit reimbursement of Sanexas or vitamin injections used in conjunction with Sanexas in the way in which Healing Place administered them. In particular, National Coverage Determination 160.7.1 states: “Electrical nerve stimulation treatments furnished by a physician in his/her office, by a physical therapist or outpatient clinic are excluded from coverage by § 1862(a)(1) of the Act.” Similarly, Local Coverage Determination (“LCD”) 35222 reinforces that “[t]he use of electrostimulation alone for the treatment of multiple neuropathies or peripheral neuropathies caused by underlying systemic diseases is not medically reasonable and necessary.” Other LCDs contain the same or similar statements, such as L35456, L35457, L37642, and L36850.
