Two PA Chiropractic Practices Pay Over $800,000 to Resolve Alleged False Claims Act Liability Arising from Billing of P-Stim Devices
PHILADELPHIA (STL.News) Acting United States Attorney Jennifer Arbittier Williams announced that two related, integrative chiropractic practices and their chiropractor owners have agreed to make payments totaling $805,978 to resolve liability under the False Claims Act for the alleged improper billing of P-Stim electro-acupuncture devices, in these cases branded ‘ANSiStim.’
The settling parties are: (1) Discover Optimal Healthcare of Brookhaven, PA, with its owner, Jason Weigner, and his affiliate Weigner Healthcare Management Group, LLC (collectively, “Weigner”); and (2) Yucha Medical Pain Management & Chiropractic Rehabilitation, LLC of Pottstown, PA, and its owners, Randolph E. Yucha and Rodney Gabel (collectively, “Yucha”).
Chiropractors are generally limited in what services they can bill to federal healthcare programs. However, integrative chiropractic practices such as Weigner and Yucha may in certain circumstances bill additional services to federal healthcare programs through affiliated medical providers, in this case a medical doctor contractor. From approximately September 2016 to February 2017, Weigner and Yucha separately billed Medicare, and Weigner also billed the Federal Employees Health Benefit Program, for the implantation of neuro-stimulators – a surgical procedure which usually requires an operating room and which is reimbursed by federal healthcare programs – when in fact the only procedures performed had been the non-surgical application of ANSiStim by a non-surgeon contractor physician. ANSiStim is another brand name for the P-Stim device, which is also branded as NeuroStim, Stivax, E-Pulse, and NSS-2 Bridge. ANSiStim devices are applied with an adhesive and insertion of a limited number of needles; their application does not involve surgery or anesthesia, nor does it take place in an operating room. Federal healthcare programs do not reimburse for devices such as ANSiStim, whether they are characterized as an electro-acupuncture device or as an implantable neuro-stimulator. Weigner promoted this scheme to Yucha and received a portion of Yucha’s profits.
For the fraudulently billed P-Stim services here, Weigner previously repaid $306,342 to Medicare and will pay an additional $356,150. Likewise, Yucha had repaid $94,089 to Medicare and will pay an additional $49,397.
“As we have said before, the application of P-Stim devices is not surgery and should not be billed using the surgical codes improperly pushed by marketers,” said Acting U.S. Attorney Williams. “If a marketer pushes a healthcare scheme like P-Stim that sounds too good to be true, it likely is – and you shouldn’t agree to it.”
These are the fourth and fifth P-Stim provider settlements announced in this District as part of an ongoing investigation. Other jurisdictions including the Southern District of Texas, the Southern District of Georgia, and the Middle District of Tennessee have also taken action to hold providers accountable.
Acting U.S. Attorney Williams continued: “Our continued enforcement through this series of cases has already recovered millions and is a lesson to anyone who might consider a similar fraudulent billing scheme – especially those that prey on vulnerable Medicare beneficiaries looking for legitimate pain management solutions. You will be held accountable by our Office and our partners at the Centers for Medicare & Medicaid Services’ Center for Program Integrity, the Department of Health and Human Services Office of Inspector General, other federal healthcare programs, state partners, and sister U.S. Attorney’s Offices around the country. And if you have already been involved in such a scheme, it is better to come forward and self-disclose than have us find you, as we will.”
“Every time DOJ stops a provider who is committing fraud, it protects patients and improves the sustainability of the Medicare program,” said Chiquita Brooks-LaSure, Administrator for the Centers for Medicare and Medicaid Services (CMS). “Actions like this to combat fraud, waste and abuse in our federal programs would not be possible without the successful partnership of CMS, the Department of Justice and Department of Health and Human Services Office of Inspector General.”
“Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General. “HHS-OIG, CMS’s Center for Program Integrity, and the U.S. Attorney’s Office will continue to evaluate and pursue inaccurate billings of P-Stim and similar devices.”
The settled civil claims are allegations only. There has been no determination of civil liability. This case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General. It was handled by Assistant U.S. Attorney Matthew E. K. Howatt, Civil Chief Gregory B. David, and Auditor Dawn Wiggins.