FLORIDA
Flordida-based Logan Laboratories Inc., Tampa Pain Relief Centers Inc. (Tampa Pain), a pain clinic along with two of their former executives, Michael T. Doyle and Christopher Utz Toepke agreed to pay $41 million for allegedly billing federal health care programs for unnecessary Urine Drug Testing, officials announced Wednesday.
Both Logan Labs and Tampa Pain are subsidiaries of Surgery Partners Inc.
Doyle is the former CEO of Surgery Partners and Logan Labs.
Toepke is the former Group President for Ancillary Services at Surgery Partners, with oversight of Logan Labs, and a former Vice President at Tampa Pain.
The allegations that are the subject of today’s settlement were originally alleged in two cases filed under the whistleblower, or qui tam, provision of the False Claims Act.
The whistleblowers will receive approximately $7.79 million of the settlement.
The claims resolved by this settlement are allegations only and there has been no determination of liability.
The government alleged that Defendants knowingly submitted false claims to federal health care programs for presumptive and definitive UDT, in circumstances where such testing was not medically reasonable or necessary.
Presumptive UDT are tests that screen for the presence of drugs, and definitive UDT are tests that identify the amounts of those drugs in a patient’s system, according to officials.
The government alleged that Defendants developed and implemented a policy and practice of automatically ordering both presumptive and definitive UDT for all patients at every visit, without any physician making an individualized determination that either test was medically necessary for the particular patients for whom the tests were ordered.
According to the government’s allegations, the medically unreasonable and unnecessary definitive UDT were performed at Logan Labs and Tampa Pain, and the respective resulting false claims were submitted by both Tampa Pain and Logan Labs to federal health care programs, from Jan. 1, 2010 through Dec. 31, 2017.
“The indiscriminate and unnecessary testing alleged here increased medical costs to the government without serving patients’ real medical needs,” said U.S. Attorney William M. McSwain for the Eastern District of Pennsylvania. “A laboratory that promotes and knowingly conducts medically unnecessary drug testing – prioritizing profits over objective medical decision-making – operates unlawfully and wastes limited federal health care resources. That is unfair to both patients and taxpayers and is the type of conduct that must be rooted out of our health care system.”
Contemporaneous with the False Claims Act settlement, Logan Labs entered into an “Integrity Agreement” and Tampa Pain entered into a “Corporate Integrity Agreement” with the Department of Health and Human Services, Office of Inspector General.
“Increasing the profits of a sister-company by referring patients for testing services that are not medically reasonable and necessary and then having that sister-company submit claims to government health insurance programs for those needless services drains resources from legitimate patient care,” said Omar Pérez Aybar, Special Agent in Charge, Office of Inspector General of the Department of Health and Human Services. “Those scheming to enrich themselves at the expense of taxpayer-funded programs must be held accountable for their actions.”
“It’s offensive when medical providers choose to bilk our healthcare billing system for personal enrichment,” said Special Agent in Charge Cynthia A. Bruce, Defense Criminal Investigative Service (DCIS) Southeast Field Office. “DCIS and our investigative partners are dedicated to fully investigate and bring to justice those who deprive the Department of Defense of limited resources needed for the healthcare of our military, veterans, and their families.”