Columbia, South Carolina --- The United States has filed a
complaint under the False Claims Act against Daniel McCollum, a chiropractor
based in Greenville, South Carolina, and pain management clinics and urine drug
testing laboratories that McCollum owned or managed for engaging in illegal
financial relationships and providing medically unnecessary services and items,
including urine drug testing and steroid injections and prescriptions for
opioids and lidocaine ointment, the Department of Justice announced today. The
entities named as defendants in connection with McCollum’s schemes are
FirstChoice Healthcare P.C.; Labsource LLC; Oaktree Medical Centre P.C.; Pain
Management Associates of the Carolinas LLC; Pain Management Associates of North
Carolina P.C.; and ProLab LLC. The United States’ complaint also names as a
defendant ProCare Counseling Center LLC, a substance abuse counseling center
located in Greenville, South Carolina, that the government contends referred
medically unnecessary urine drug tests to ProLab, which it co-owned with
McCollum.
“Individuals
and entities that participate in federal health care programs must comply with
the rules intended to safeguard the integrity of those programs,” said
Assistant Attorney General Jody Hunt of the Department of Justice’s Civil
Division. “We will not tolerate practices such as the ordering of unnecessary
items or services and providing illegal inducements to physicians that lead to
excessive costs being imposed upon our nation’s health care programs.”
“The U.S.
Attorney’s Office for the District of South Carolina will not tolerate health
care fraud, which victimizes both patients and taxpayers,” said Sherri Lydon,
United States Attorney for the District of South Carolina. “We are committed to
protecting taxpayer dollars from fraudulent billing practices and to holding
accountable those in the medical community who have fueled the opioid crisis
through abusive prescribing habits. Through False Claims Act cases like this
one, we will continue to bring these bad actors to justice.”
The United
States’ complaint alleges that from at least Jan. 1, 2011 through Dec. 31,
2018, McCollum and his pain management clinics paid bonuses to physicians and
other health care providers that included amounts based directly on their referrals
of urine drug testing to McCollum’s laboratories, in violation of the Stark Law
and the Anti-Kickback Statute. The United States also alleges that McCollum and
Labsource violated the Anti-Kickback Statute by entering into “direct bill”
agreements with physicians and other providers around the country that entitled
those providers, after paying Labsource a set fee to run the test panels they
ordered, to bill private insurance companies directly for those tests – and
generally for much more than they had paid Labsource. The United States
contends in its complaint that McCollum and Labsource offered providers the
opportunity to profit in this manner to induce them to refer their tests for
Medicare, Medicaid, and TRICARE patients to Labsource.
Congress
passed the Stark Law and Anti-Kickback Statute to prevent financial incentives
from improperly influencing medical decision-making, which can lead to
excessive and unnecessary tests and services, as well as patient harm. Among
other things, the Stark Law prohibits billing Medicare for laboratory testing
services referred by a physician who stands to profit directly from those
referrals. The Anti‑Kickback Statute, in relevant part, prohibits offering
or paying anything of value to encourage the referral of items or services
covered by federal health care programs, including laboratory testing services.
The United
States’ complaint also alleges that McCollum and the other defendants,
including ProCare, directed or encouraged providers to use “standing orders” of
laboratory tests across all or most of their patients without regard for
individual patient need – which caused Medicare, Medicaid, and TRICARE to pay
for medically unnecessary tests. Finally, the complaint alleges that McCollum
and his pain management clinics caused these federal health care programs to
pay for excessive and unnecessary steroid injections and unnecessary
prescriptions for opioids and lidocaine ointment.
The United
States filed its complaint in three consolidated lawsuits pending in the United
States District Court for the District of South Carolina under the qui tam, or
whistleblower, provisions of the False Claims Act. Under the Act, a private
citizen can sue on behalf of the government and share in any recovery. The
United States also is entitled to intervene in the lawsuits, as it did in these
cases on March 1.
This matter
was investigated by the Commercial Litigation Branch of the Department of
Justice’s Civil Division, the U.S. Attorney’s Office for the District of South
Carolina, the FBI, the Department of Health and Human Service’s Office of
Inspector General, the South Carolina Attorney General’s Office, and the
Defense Criminal Investigative Service. It was handled by Assistant United States
Attorney Beth Warren for the District of South Carolina. The claims asserted in
this action are allegations only, and there has been no determination of
liability.
The
consolidated civil cases are United States ex rel. Rauch, et al. v. Oaktree
Medical Centre, P.C., et al., No. 6:15-cv-01589-DCC (D.S.C.); United States ex
rel. Mathewson v. Dr. Daniel A. McCollum, et al., No. 6:17-CV-01190-DCC
(D.S.C.); and United States ex rel. Hawkins v. Pain Management Associates of
the Carolinas, LLC, et al., No. 8:18-cv-02952-DCC (D.S.C.).
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