Align Health and Holistic Medical Center, Inc. and Align Health Management, Inc., (collectively “Align”), Eric Anderson, P.A. d/b/a Anderson Chiropractic Clinic (“Anderson Chiropractic”), their owners and a former employee have agreed to pay $163,400 to resolve allegations that they knowingly and improperly billed Medicare for electro-acupuncture using peri-auricular stimulation devices in violation of the False Claims Act. Align and Anderson Chiropractic are outpatient clinics located in Maryville, Tennessee that offer medical and chiropractic services for the treatment of pain.
According to the contentions of the United States contained in the settlement agreement, between September 2016 and March 2019 Align and Anderson Chiropractic routinely presented, or caused to be presented, to Medicare false claims for payment for the placement of electro-acupuncture devices on patients. The placement of these devices was improperly billed under code L8679, which resulted in the clinics receiving payments from Medicare to which they were not entitled.
In addition to paying the civil settlement, which was based on the parties’ ability to pay, Align, Anderson Chiropractic, and their owners have agreed to enter into an Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services (OIG-HHS). The IA requires, among other things, that Align, Anderson Chiropractic, and their owners implement specific measures intended to prevent future healthcare fraud and to address evolving compliance risks. These measures include training for staff on applicable healthcare fraud laws and submitting to a claims review conducted by an Independent Review Organization to ensure compliance with Medicare billing requirements.
