Texas Pain Doctors Agree to Pay $ 3.9 Million to Resolve Allegations of Unnecessary Urine Drug Tests | Takeover bid

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Two Texas doctors, Robert Wills and Brannon Frank, agreed to pay $ 3.9 million to resolve allegations they violated the False Claims Act by knowingly billing Medicare, Medicaid and TRICARE for urine drug tests medically unnecessary.

Settlements with Wills and Frank resolve allegations that doctors, formerly part-owners of the late Austin Pain Associates in Austin, Texas, knowingly caused false claims to be submitted to federal health programs by ordering drug tests excessive and unnecessary urination for patients. without any individualized assessment of clinical needs. As of 2011, all urine drug tests ordered by Austin Pain Associates physicians, including Wills and Frank, were performed in Austin Pain Associates internal lab. The United States alleged that Wills and Frank wrote the test protocols which resulted in unnecessary testing, was aware that the internal lab was performing an excessive number of tests on urine samples, and that Austin Pain Associates was not could not remain profitable without the income generated. unnecessary testing. Pursuant to their respective settlement agreements, Wills agreed to pay $ 2,100,000 to settle these allegations and Frank agreed to pay $ 1,800,000.

“The provision of medical services should be based on a patient’s medical needs, not a physician’s desire to increase profits,” said Acting Assistant Attorney General Brian M. Boynton of the Civil Division of the Ministry of Justice. “The Department of Justice is committed to taking appropriate measures to protect the integrity of federal health programs and the well-being of their beneficiaries. ”

“Doctors who bill taxpayer-funded health programs for costly and medically unnecessary drug tests increase the cost of health care for all of us,” said U.S. Attorney General Ashely C. Hoff for the Western District of Canada. Texas. “We will continue to vigorously investigate and prosecute allegations of false claims submitted to Medicare, Medicaid, TRICARE and any other government health program. “

“Doctors who perform medically unnecessary and excessive testing are exploiting patients and taxpayer-funded health programs,” said Special Agent in Charge Miranda Bennett of the Office of the Inspector General of the Department of Health and Human Services social (HHS OIG). “Together with our law enforcement partners, we will continue to hold accountable those who engage in false claims practices.”

“Today’s result demonstrates the commitment of the Office of the Inspector General of the Department of Defense, Defense Criminal Investigation Service (DCIS), in coordination with our law enforcement partners, to diligently investigate allegations of fraud committed against TRICARE, “said Special Agent in Charge Michael Mentavlos. from the DCIS Southwest Regional Office. “We will continue to hold accountable those who obtain taxpayer funds through false and fraudulent means. “

Medicaid is jointly funded by the states and the federal government. The state of Texas has paid a portion of the Medicaid claims at issue and will receive a total of approximately $ 260,000 from settlements with Wills and Frank.

The Civil Settlement includes the resolution of claims filed under the qui tam or whistleblower provisions of the False Claims Act by Jennifer Nuessner and Robert Hoffman, former employees of Austin Pain Associates. Under these provisions, a private party can sue on behalf of the United States and receive a portion of any recovery. As part of the resolutions with Frank and Wills, the two whistleblowers will receive a total of approximately $ 618,000 from the federal part of the settlements. The qui tam case is captioned United States ex rel. Nuessner, et al. v. Austin Pain Associates, LLC, et al., 5: 16-CV-1125-FB (WD Tex.).

The resolutions obtained in this case were the result of a coordinated effort between the Commercial Litigation Division of the Civil Division, the United States Attorney’s Office for the Western District of Texas, the HHS OIG, and the Defense Criminal Investigation Department. .

The case was handled by Attorney Jonathan Thrope of the Commercial Litigation Division of the Civil Division (Fraud Section) and Assistant U.S. Attorney Thomas Parnham for the Western District of Texas.

The claims resolved by the settlement are only allegations and there has been no determination of liability.

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