Two Texas physicians, Robert Wills and Brannon Frank, agreed to pay $3.9 million to resolve allegations that they violated the False Claims Act by knowingly billing Medicare, Medicaid and TRICARE for medically unnecessary urine drug testing
The settlements with Wills and Frank resolve allegations that the physicians, formerly co-owners of now-defunct Austin Pain Associates located in Austin, Texas submitted false claims to federal healthcare programs.
The doctors ordered excessive and unnecessary urine drug testing for patients without any individualized assessment of clinical need.
Starting in 2011, all urine drug tests ordered by Austin Pain Associates’ physicians, including Wills and Frank, were performed at Austin Pain Associates’ in-house laboratory.
The federal government alleged that Wills and Frank drafted the testing protocols that resulted in unnecessary tests, were aware that the in-house laboratory was conducting an excessive number of tests on urine samples, according to officials.
Austin Pain Associates could not remain profitable without the income generated from unnecessary testing.
As part of the settlement agreements, Wills has agreed to pay $2.1 million to settle these allegations and Frank has agreed to pay $1.8 million.
“Physicians who bill taxpayer-funded health programs for expensive and medically unnecessary drug tests increase the cost of healthcare for all of us,” said U.S. Attorney Ashely C. Hoff for the Western District of Texas. “We will continue to vigorously investigate and prosecute allegations of false claims submitted to Medicare, Medicaid, TRICARE and any other government health program.”
Medicaid is funded jointly by the states and the federal government.
The State of Texas paid for a portion of the Medicaid claims at issue and will receive a total of approximately $260,000 from the settlements with Wills and Frank, according to officials.
The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Jennifer Nuessner and Robert Hoffman, former employees of Austin Pain Associates, officials stated.
Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. As part of the resolutions with Frank and Wills, the two whistleblowers will receive a total of approximately $618,000 from the federal share of the settlements.
The qui tam case is captioned United States ex rel. Nuessner, et al. v. Austin Pain Associates, LLC, et al., 5:16-CV-1125-FB (W.D. Tex.).