Center for Interventional Pain and Spine accused of billing fraud

Spine

Wilmington, Del.-based Center for Interventional Pain and Spine, a medical group with 11 offices in Delaware, Maryland and Pennsylvania, has been accused of billing the government for unnecessary patient testing, according to a June 26 report from PBS affiliate WHYY.

A lawsuit filed by the U.S. attorney's office in Delaware has accused the center of participating in a "scheme to illegally profit" from Medicare and Medicaid programs. 

CIPS and Chee Woo, MD, its president at the time, allegedly were paid millions between 2018 and 2021 through thousands of violations of the False Claims Act.

Patients at the clinic allegedly had to submit urine samples for drug testing every three months, regardless of whether the evaluation was medically necessary. Additionally, thousands of patients allegedly also filled out psychological and neurological questionnaires with no medical reasoning or followup. 

The lawsuit accuses Dr. Woo of developing the scheme to earn additional profits and enrich his company, buying expensive equipment to evaluate patient drug tests in house instead of sending them out for analysis. 

According to the lawsuit, Dr. Woo and other facility physicians "routinely failed to perform any risk assessment prior to ordering" the drug screens, and notes in patients' medical records often did not contain any "documentation of medical necessity" for the testing. 

The lawsuit seeks repayment to the government plus interest and penalties, and for CIPS to cover the cost of investigating and prosecuting the case.

Ronald Chapman, Dr. Woo's attorney, told WHYY the company plans to contest the lawsuit and will file a dismissal motion. 

"Our position and the position of the American Society of Interventional Pain Physicians is that you should determine what risk a patient might have, and then urine drug test them appropriately according to that risk, and that's exactly what the practice did. Unfortunately, Medicare and other insurance guidance in this arena has shifted heavily over time and it's been incredibly vague,"Mr. Chapman said. "This practice provides pain management to a large amount of the population in Delaware and other states because of its size, and they're a vital service for folks in debilitating pain."

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.