The U.S. Attorney’s Office for the Middle District of Tennessee on Thursday announced it reached a $1.5 million settlement to resolve allegations that it completed medically unnecessary diagnostic testing and submitted the claims to the U.S. Department of Veterans Affairs and Medicare.
According to the U.S. Department of Justice (DOJ), the settlement involved Michael and Debbie Cox of the Clarksville Pain Institute and Pain Institute of Nashville, who prosecutors alleged submitted claims for unnecessary tests, including “urine drug testing, allergy testing, and psychological testing,” for about a decade between 2014 and 2024.
Debbie Cox held an ownership interest in both clinics, which merged in 2018, according to the DOJ press release.
“Federal health care programs exist to provide necessary medical care, not to generate payments for unnecessary testing,” stated U.S. Attorney Braden Boucek.
“When providers allegedly misuse these programs for financial gain, they undermine public trust and divert taxpayer dollars from legitimate patient care,” said Boucek. “Our office will continue working with our federal partners to protect the integrity of these programs and hold those who submit false claims accountable.”
The DOJ also said the settlement resulted from whistleblower litigation by former employee Krista Nicholson, who filed her lawsuit under the False Claims Act, which allows a private citizen to sue on behalf of the federal government.
As a result of her litigation, the DOJ said Nicholson will receive $285,000 from the $1.5 million settlement.
This is the latest in a series of False Claims Act lawsuits that have recovered taxpayer money for the federal government. Between September 30 and October 22, prosecutors in East Tennessee announced three settlements from False Claims Act litigation, resulting in a total of $8.3 million recovered for taxpayers.
One case involved a Chilean-owned plastics company in Knoxville that allegedly failed to count its foreign workforce when applying for a Paycheck Protection Program (PPP) loan during the COVID-19 pandemic. The company agreed to repay $2.25 million as a result of a False Claims Act lawsuit.
– – –
Tom Pappert is a 2025 recipient of the Dao Prize and the lead reporter for The Tennessee Star. He also reports for the Star News Network. Follow Tom on X. Email tips to [email protected].
