A physician who owns pain management clinics and surgery centers in Middlesex and Union counties, as well as in New York, has agreed to pay $7.4 million to settle a whistleblower lawsuit that alleged Medicare billing fraud.
The whistleblower case, filed by Phillips & Cohen LLP which the U.S. Department of Justice joined, alleged Dr. Amit Poonia and his pain management clinics and surgery centers billed Medicare for procedures that Medicare doesn’t cover and received reimbursement for them.
The lawsuit alleges Poonia and his businesses violated the False Claims Act by submitting false claims to Medicare for the implantation of two different devices to treat pain.
The devices, known as “P-Stims” (percutaneously placed microchip-controlled pulsed neurotransmitters) and “NSS” (Neuro-Stim System) are considered acupuncture under Medicare guidelines, according to Emily Stabile, a whistleblower attorney at Phillips & Cohen, who added that with few exceptions, Medicare does not allow billing for acupuncture procedures.
“This settlement holds the defendants accountable for mischaracterizing acupuncture as a surgical procedure in order to dishonestly obtain millions of dollars from Medicare and the Federal Employees Health Benefit Program,” said Breon Peace, United States Attorney for the Eastern District of New York.
P-Stim and NSS procedures transmit electrical pulses through needles placed just under the skin on a patient’s ear. Both treatments are considered acupuncture...
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