|Lenoir City chiropractor pays $1.45 million over
improper billing to federal, state health programs
NASHVILLE — A Lenior City chiropractor has paid $1.45 million, plus interest, to resolve claims of improperly billing federal and state health programs for prescription painkillers.
Under a settlement agreement with federal prosecutors, Matthew Anderson and his management company, PMC LLC, paid a total of $1,450,000, plus interest, according to a U.S. Department of Justice news release. The United States will receive $1,040,275, and Tennessee will receive $163,225.
Anderson and PMC, who managed four now defunct pain clinics in Tennessee, also agreed to be excluded from billing federal health care programs for five years. Three of the clinics will also forfeit $53,840, which the United States seized from the clinics’ bank accounts.
The pain clinics were most recently known as the following: Cookeville Center for Pain Management; Spinal Pain Solutions in Harriman; Preferred Pain Center of Grundy County in Gruetli Laager; and McMinnville Pain Relief Center.
The settlement resolves the governments’ claims that from 2011 through 2014, they caused pharmacies to submit requests for Medicare and TennCare payments for painkillers, including opioids, which were dispensed based upon prescriptions written at the Cookeville Center for Pain Management and which had no legitimate medical purpose, according to the release.
The United States also contended that Anderson caused all four clinics to bill Medicare for upgraded claims for office visits that were not reimbursable at the levels sought. In addition, the United States claimed Anderson and PMC caused the submission of Medicare claims by the Cookeville and Harriman clinics for services provided by two nurse practitioners who were not collaborating with a physician as required by state law during parts of 2011 and 2012.
The settlement agreement also calls for Cindy Scott, a nurse practitioner from Nashville, to pay $32,000 and to surrender her DEA registration until October 2021.
The investigation began after a former office manager for the Cookeville Center for Pain Management filed a whistleblower lawsuit against Anderson, Scott and three of the pain clinics, according to the release. Under provisions of the False Claims Act, the whistleblower will receive $246,500 under the settlement with Anderson and lesser amounts under the settlements with Scott and the three pain clinics.