Tri-State Health Centers Agree To $7.5M Deal, Ending FCA Claims

A collective of New York and New Jersey medical and surgery locations have agreed to pay a settlement of more than $7.5 million to end FCA allegations that they incorrectly billed the federal government for various acupuncture treatments over a span of 4 years.

NJ FCAPhoto Credit: Shutterstock

Dr. Amit Poonia allegedly owns the health offices and surgery centers that will ultimately pay $7,447,340.75 to end the False Claims Act case according to a Wednesday announcement from the federal government, which intervened in the case.

The allegations, initially filed by two former employees, included claims that patients at numerous facilities received treatment with “electro-acupuncture devices,” that fit on the ear and emit electrical pulses beneath a wearer’s skin.

According to the U.S. Attorney’s Office for the Eastern District of New York, federal guidelines consider the procedure acupuncture, which the government does not reimburse providers for.

“Medical professionals are expected to bill taxpayer funded health care programs correctly to ensure that they remain solvent and available to those that need their services,” said Scott J. Lampert, special agent-in-charge at the U.S. Department of Health and Human Services’ Office of the Inspector General, in an official statement.

The government alleges that the offices purposely used wrong billing codes as a workaround to the acupuncture reimbursement obstacle.

Lakshmi Anu Doddapaneni and Christian Reyes were the former employees who initially filed the lawsuit in 2018 after internally voicing their concerns for patients.

“Our clients were very concerned about the high number of procedures that the clinics were recommending and performing,” stated Colette Matzzie, an attorney for the plaintiffs, in a statement. “Ms. Doddapaneni and Mr. Reyes cared a great deal about the patients, many of whom suffer from chronic pain.”

Poonia said in his statement that Centers for Medicare & Medicaid Services “contractors conducted medical record reviews multiple times of certain of the … practices’ billings for the treatments of [the acupuncture devices] that are of issue in 2015, and again in 2019, and determined that the services were payable as billed.”

Poonia added that the centers were “planning on bringing a lawsuit against the manufacturers and marketers of” the acupuncture devices that he said had intensely urged “providers to bill federal healthcare programs for the use of these devices and providing incorrect coding and billing guidance.”

Poonia made it a point to highlight that “the practices cooperated with the government’s investigation and agreed from the beginning to return the alleged overpayments.”

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