Five details:
1. James Anderson, MD, owner of Goodlettsville-based Affiliated Neurologists; Charles F. Spencer, DC, owner of Murfreesboro-based Total Family Health & Wellness; and Mitchell Shea, DC, owner of Cookeville-based Chiro2Med of Tennessee are accused of billing Medicare and TennCare for electro-acupuncture using a periarticular stimulation device that doesn’t qualify for reimbursement from the payers.
2. The three providers billed for P-stim devices under the HCPCS Code L8679, which requires implanting a neurostimulator with anesthesia in a surgical setting by a physician, from May 2016 to November 2018.
3. Tennessee brought the suit against Dr. Anderson in June, and he agreed to pay $1 million to the U.S. and Tennessee over a five-year period. He also signed an integrity agreement with the HHS Office of the Inspector General to undergo regular monitoring of his billing practices for the next three years.
4. Dr. Spencer and Total Family will pay the U.S. $700,000 in the next five years to settle the claims.
5. Dr. Shea and Chiro2Med will pay $20,000 to the U.S. over five years.
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