On June 26, Associated Pain Specialists, P.C., of Knoxville, a pain management-based clinic, agreed to pay $400,000 to resolve allegations of violating the False Claims Act. The settlement resolves allegations that from February 1, 2016 through August 10, 2018, Associated Pain Specialists, P.C. knowingly billed Medicare and Tennessee Medicaid (TennCare) for medically unnecessary screening tests at higher costs than appropriate, when less costly or alternative tests were available. The government alleged that Associated Pain Specialists, P.C. performed tests on patients whose medical records did not support a medical diagnosis for the tests and the associated billing codes. The government also alleged the Vital System Assessment Tests (VSAT) did not benefit patients because the test results were not used in the treatment subsequently provided, and that, ultimately, Associated Pain Specialists, P.C. knowingly submitting false claims to federal healthcare programs for payment for VSATs that were not reasonable or medically necessary. Allegations were brought in a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act. As part of the settlement, Associated Pain Specialists, P.C., entered an Integrity Agreement (IA) with HHS-OIG which promotes its future compliance with the statutes, regulations, program requirements, and written directives of Medicare and all other federal healthcare programs. The IA focuses on the pain clinic’s continuing obligation to accurately bill and properly submit reimbursement claims to Medicare and TennCare.
