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National Spine & Pain Center to pay $5.1M billing fraud settlement: 5 details

A Rockville, Md.-based spine and pain center chain will pay millions to resolve Medicare fraud claims.

Five details:

1. National Spine & Pain Center admitted to contracting with Proove Biosciences, a defunct genetics testing company, to pay physicians for referrals disguised as compensation for a clinical research program.

2. Proove allegedly paid National Spine & Pain Center physicians per test and per patient to complete timesheets saying they spent more time than they did with patients on clinical research. Some physicians also said they performed tasks on the timesheets when Proove employees completed the tasks.

3. National Spine & Pain Centers said its team told Proove it would not provide genetic testing unless the company stayed current on payments, and Proove set expectations for the physicians to order a certain number of tests.

4. Physical Medicine Associates, a physician group associated with National Spine & Pain Center, received $1.1 million from Proove, and Medicare paid Proove $4 million for the fraudulent claims.

5. National Spine & Pain Center agreed to pay $5.1 million in restitution to settle allegations that its agreement with Proove violated the Anti-Kickback Statute.

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