a $24.5 million settlement to resolve healthcare fraud allegations that it violated the False Claims Act and billed federal healthcare programs for unnecessary medical testing and services.
PPOA founder Rodolfo Gari and former chief medical officer Abraham Rivera are also liable for the settlement amount, along with PPOA affiliated entities, including the Florida Pain Relief Group, the Texas Pain Relief Group, Physician Partners of American CRNA Holdings LLC, Medical Tox Labs LLC, and Medical DNA Labs LLC.
The US Department of Justice (DOJ) alleged that PPOA submitted claims to federal healthcare programs for medically unnecessary urine drug testing.
According to the case, PPOA required its physician employees to order multiple tests simultaneously without reviewing initial test results to determine if the additional testing was reasonable or needed. The health system’s affiliated toxicology lab then billed federal healthcare programs for the highest level of urine drug testing
DOJ claimed that in exchange for ordering fraudulent urine drug tests, PPOA offered physicians 40 percent of the profits from the testing. This violates the Stark Law, which prohibits physicians from referring patients to receive health services payable to Medicare and Medicaid from entities with which the physician has a financial relationship.
Additionally, PPOA required patients to undergo medically unnecessary genetic and psychological testing before being seen by physicians....
A front-page article with the byline of veteran New York Times opinion writer Nicholas Kristof is the latest poisonous example of what I call the NGO “halo effect.” Headlined “The Silence That Mee...