U.S. Attorney's Office for the Eastern District of Pennsylvania issued the following announcement on Sept. 17.
First Assistant U.S. Attorney Jennifer Arbittier Williams announced that Richard P. Frey, D.O., and Physicians Alliance Ltd. (“PAL”) have agreed to pay $178,398.35 to resolve liability under the False Claims Act for the alleged improper billing of “P-Stim” devices.
From May 2013 through June 2014, Frey and PAL billed Medicare for the implantation of neurostimulator electrodes, a surgical procedure typically necessitating an operating room for which Medicare reimburses thousands of dollars. Frey did not conduct surgery, however. Instead, he applied a “P-Stim” device in an office setting without surgery or anesthesia.
P-Stim is an electric acupuncture device that, pursuant to manufacturer’s instructions, is affixed behind a patient’s ear using an adhesive. Needles are inserted into the patient’s ear and affixed using another adhesive. Once activated, the device then provides intermittent stimulation by electrical pulses. It is a single-use, battery-powered device designed to be worn for approximately four days until its battery runs out, at which time the device is thrown away. Medicare does not reimburse for acupuncture or for acupuncture devices such as P-Stim, nor does Medicare reimburse for P-Stim as a neurostimulator or as implantation of neurostimulator electrodes. Other brand names for this device include Stivax, NeuroStim, ANSiStim, E-Pulse, and NSS-2 Bridge.
“P-Stim is an acupuncture device that was billed here as a surgically implanted neurostimulator,” said First Assistant U.S. Attorney Williams. “Medicare does not reimburse a dime for acupuncture devices, but it paid these defendants thousands of dollars because of their alleged improper billing. We appreciate Dr. Frey and PAL’s willingness to promptly negotiate a resolution in this matter, and we will continue working closely with our partners at CMS’s Center for Program Integrity, the Department of Health and Human Services Office of the Inspector General, and sister U.S. Attorney’s Offices around the country to hold accountable any other providers who inappropriately billed for this device and any distributors or marketers who carried out such a billing scheme.”
“Every dollar saved is critical to the sustainability of our Medicare program and the needs of our beneficiaries,” said Centers for Medicare and Medicaid Services Administrator Seema Verma. “We thank our partners at the Department of Justice and Department of Health and Human Services Office of Inspector General for working hard with us to identify, investigate, and eliminate waste, fraud and abuse in our federal healthcare programs.”
“Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General. “HHS-OIG, CMS’s Center for Program Integrity, and the U.S. Attorney’s Office will continue to evaluate and pursue inaccurate billings of P-Stim and similar devices.”
The settled civil claims are allegations only. There has been no determination of civil liability. This case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General. It was handled by Assistant U.S. Attorney Matthew E. K. Howatt, Civil Chief Gregory B. David, and Auditor Dawn Wiggins.
Original source can be found here.