Former Tennessee State Sen. Steve Dickerson and past associates of his will have to pay more than $4.1 million to settle claims that their medical service engaged in wrongdoing.
This, according to a press release that staff members at the U.S. Attorney’s Office for the Middle District of Tennessee published this week.
Dickerson was one of four majority owners of Anesthesia Services Associates, PLLC, doing businesses as Comprehensive Pain Specialists (CPS), based in Brentwood. The other three majority owners are Peter B. Kroll, Gilberto A. Carrero, and Richard J. Muench. The U.S. Attorney’s Office also cites former CPS executive Russell S. Smith. They will pay more than $4.1 million to settle claims that Tennessee and U.S. government officials leveled against them, according to the press release.
CPS at one point operated more than 40 pain clinics and operated in 12 states, until it shut down in 2018, the press release said.
“On July 22, 2019, the United States and Tennessee filed a Consolidated Complaint in Intervention in the United States District Court for the Middle District of Tennessee against CPS, its former CEO, John Davis, who was convicted in April 2019 of health care fraud, as well as three of the four principal owners, Drs. Kroll, Dickerson, and Carrero, and, Dr. Smith, a former manager of certain CPS clinics in East Tennessee (the ‘Civil Action’). The complaint alleged, among other things, that the defendants submitted false claims for medically unnecessary and/or non-reimbursable testing and acupuncture. Dr. Muench, the only owner not a party to the lawsuit, agreed to settle with the United States and Tennessee prior to the filing of the Complaint,” the press release said.
“The agreements with CPS and the owners resolve the United States’ and Tennessee’s claims for violations of the False Claims Act and the Tennessee Medicaid False Claims Act that arose from the submission of false claims to federal health care programs and TennCare specifically for medically unnecessary and/or non-reimbursable urine drug, specimen validity, genetic and psychological testing, as well as claims for electro-auricular acupuncture during the period from May 2011 through when CPS ceased operating in 2018. The settlement also resolves claims relating to CPS’s submission of false claims under Dr. Kroll’s provider number for services he did not render and testing he did not order. In addition, the agreements resolve common law claims for fraud, payment by mistake, and unjust enrichment against CPS, the Owners and Dr. Smith.”
To resolve the Civil Action, CPS agreed to release more than $2.1 million in funds held by Medicare in a suspension account and will contribute an additional $750,000 in cash. The Owners will pay a total of $1.05 million to resolve claims against them. Smith also agreed to pay $125,000 to resolve potential liability for common law claims that could be brought against him by the United States and Tennessee. As part of the settlements, the United States and Tennessee agreed to dismiss the civil action, except for their claims against John Davis.
“The allegations resolved by this settlement were originally raised in lawsuits filed under the qui tam, or whistleblower, provisions of the FCA, which allow private citizens with knowledge of false claims to bring civil suits on behalf of the government and to share in any recovery,” according to the press release.
“The whistleblowers will receive $610,684.62 as their share of the governments’ settlement proceeds from the CPS settlement and will dismiss their individual actions.”
As The Tennessee Star reported in 2019, CPS allegedly instituted policies to maximize profits through medically unnecessary and excessive testing, including a standing order to automatically conduct quantitative drug testing, specimen validity testing, genetic blood testing and psychological testing on virtually all patients, without regard to individual patient risks or need, Cochran’s statement said. In July 2012, CPS began operating its own testing facility in Franklin. To ensure more revenue was generated, CPS required providers to send all urine specimens and blood work to its lab for testing. The reimbursement rate for lab testing is nearly five times the rate of on-site testing.
– – –