Doctor Agrees to Pay $ 375,000 to Resolve Allegations of Fraud on P-Stim Devices Under the False Claims Act | USAO-SDMS

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Gulfport, Mississippi – A Mississippi doctor and his family practice have agreed to pay $ 375,000 to resolve allegations of P-Stim device fraud under the False Claims Act, US Attorney Darren J. LaMarca said .

Kevin Cooper MD and his family practice, Cooper Family Medical Center, agreed to pay $ 375,000 to resolve allegations that they knowingly and improperly billed Medicare for acupuncture devices in violation of the False Claims Act (” FCA ”).

The United States alleges that over a one-year period, Dr. Cooper, through Cooper Family Medical Center, billed Medicare over $ 900,000 for non-reimbursable acupuncture devices which were not surgically implanted despite the use of billing codes indicating that they were. As noted in the Settlement Agreement, the United States alleges that from July 2018 to August 2019, Dr. Cooper routinely submitted or caused to be false statements to Medicare using code CPT L8680 (Implantable Neurostimulator, Generator ‘impulses) and / or CPT Code 64555 (implantation of peripheral nerve electrodes, accessible through the skin), and received $ 179,106.72 from Medicare to which he and his clinic were not entitled.

P-Stim is an electro-acupuncture device that, according to the manufacturer’s instructions, is affixed behind a patient’s ear using an adhesive. The needles are inserted into the patient’s ear and secured with another adhesive. Once activated, the device then provides intermittent stimulation by electrical pulses. This is a single-use, battery-powered device designed to be worn for approximately four days until its battery runs out, after which the device is discarded. Medicare does not reimburse for such acupuncture devices, nor did Dr. Cooper perform the surgical implantation of these devices as he billed Medicare. Other brands of this device include Stivax, NeuroStim, ANSiStim, E-Pulse, and NSS-2 Bridge.

“This office will hold accountable providers who are unduly paid for non-reimbursable acupuncture under the guise of surgically implanted neurostimulators,” said US Attorney Darren LaMarca.

The FCA claims settled are allegations only, and there has been no determination of liability. This case was investigated by the Office of the Inspector General of the US Department of Health and Human Services.

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