An Austin-based pain management doctor and his medical practice have agreed to pay more than $13.6 million to settle allegations that they improperly billed federal and state health care programs for urine drug testing, according to federal prosecutors.
Dr. Mark Malone, the founder of Advanced Pain Care, and more than a dozen related entities will pay $13.6 million to the United States and the state of Texas to resolve the claims under the federal False Claims Act and Texas law.
The federal government will receive the vast majority of the settlement, while Texas will receive about $34,000, officials said.
Advanced Pain Care operates pain medicine clinics and surgical centers across Texas, including locations in Austin, Amarillo, Waco and Houston. Malone is an interventional pain management physician who founded the practice.
Federal authorities alleged that from 2017 through 2021, Malone and Advanced Pain Care knowingly submitted false claims to Medicare, Medicaid, TRICARE and other government health programs for urine drug tests that were not medically necessary. Prosecutors said the practice billed for both preliminary and more advanced drug tests on the same patients and dates of service without first reviewing initial results to determine whether further testing was warranted.
The government also alleged the practice used multiple billing codes for individual drug analytes when billing the Department of Veterans...
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