Three physicians affiliated with Rockville, MD.-based National Spine & Pain Centers have been named as defendants in a $3.5 million kickback scheme that allegedly ordered unnecessary genetic tests for Medicare and Medicaid patients, The Orange County Register reported July 21.
Proove Biosciences founder and President Brian Javaade Meshkin was arraigned July 12 in U.S. District Court in San Diego on multiple charges that include conspiracy to defraud the U.S. government and making illegal payments.
The indictment also named three former Proove Biosciences executives as co-conspirators: Steven Samuel Fichtelberg, Kirt Thomas Pfaff and Bruce Walter Gardner.
The company offered pharmacogenetic tests intended to determine a patient's risk of abusing opioids and how patients metabolized certain drugs, according to the report.
The alleged scheme paid pain management physicians kickbacks ranging from $100 to $150 for each test ordered for Medicare and Medicaid patients
Proove, under the direction of Mr. Meshkin, allegedly submitted about $45 million in Medicare claims for genetic tests that were "tainted by illegal kickbacks," according to the indictment, with CMS paying the company about $20 million between 2013 and 2017.
Defendants concealed the scheme by disguising the bribes as clinical research fees, the U.S. Department of Justice alleges.
Representatives of National Spine & Pain Centers representatives allegedly said they would stop ordering Proove's genetic tests until it was paid overdue kickbacks, according to the report. In a March 2016 email, Mr. Meshkin seemed to suggest that the issue could be resolved if the practice ordered more tests.
"We get a ton of emails about payment from you guys, but your volume keeps going down. It's down 50 percent from last month," Mr. Meshkin allegedly stated in the email, according to The Orange County Register. "Fifty percent reduction in volume is completely unacceptable from our standpoint. If we could spend a little more time working on performance and volume, everything would work more effectively."
In August 2019, National Spine and Pain Centers and another pain management group in Virginia paid the Justice Department $3.3 million to settle allegations that they illegally billed for medical services as if they were provided by physicians, when they were actually performed by physician assistants and nurse practitioners.