Baltimore Doctor to Pay $436,000 to the United States to Resolve False Claims Act Allegations Relating to Medically Unnecessary Procedures

Baltimore, Maryland – Ebenezer Quainoo, M.D., an internist in Baltimore, Maryland, who operates a medical practice known as Baltimore Health Care, P.C., has agreed to pay the United States $436,000 to settle allegations that he submitted false claims to the United States for medically unnecessary autonomic nervous function tests and trigger point injections with the use of ultrasound guidance.

The settlement agreement was announced today by United States Attorney for the District of Maryland Robert K. Hur and Maureen Dixon, Special Agent in Charge of the Office of Inspector General for the Department of Health and Human Services.

In his practice, Dr. Quainoo administered peripheral autonomic nervous function tests and he performed trigger point injections using ultrasound guidance.  Autonomic nervous function disorders are relatively uncommon disorders and tests conducted to determine such disorders should be done only after a clinician suspects an autonomic nervous function disorder.  Furthermore, such tests should be conducted only one time per beneficiary, with the necessary equipment, and only by clinicians with specialized training to administer and interpret these tests.   

Trigger point injections may be indicated to treat patients with localized muscle pain in places where there are palpable and painful knots or nodules, but only after non-invasive medical management, such as muscle relaxers, topical analgesics and physical therapy, prove unsuccessful.

According to the settlement agreement, from July 24, 2014 to November 30, 2018, Dr. Quainoo submitted claims to Medicare for medically unnecessary autonomic nervous function tests and trigger point injections using ultrasound guidance.  The United States alleged that autonomic nervous function tests were not medically necessary because Dr. Quainoo lacked the necessary equipment to conduct the tests, the patients did not have an autonomic nervous function disorder before the test was conducted, Dr. Quainoo lacked the specific training to conduct such tests, and he only used the tests to monitor patient symptoms, not make any clinical decisions about future patient care.

As to the trigger point injections, the United States alleged that these procedures were not medically necessary because Dr. Quainoo failed to document a muscular knot or nodule before the patient underwent the injections, Dr. Quianoo failed to exhaust conservative treatments or therapy before performing the injections, and ultrasound guidance was not needed to perform the injections because the site of the muscle knot should be palpable; otherwise, there is no indication to perform the treatment.  

The claims resolved by this settlement are allegations.  The settlement is not an admission of liability by Dr. Quainoo, nor a concession by the United States that its claims are not well founded.

The civil settlement reached by the U.S. Attorney’s Office for the District of Maryland arose from an initiative launched by the U.S. Attorney’s Office, which involves the use of specialized resources and personnel to review Medicare billing data.  The review of that data has enabled the United States Attorney’s Office to identify areas of concern where it appears that billing irregularities may have taken place.  Partnering with the affected agencies, the United States Attorney’s Office has developed the ability to investigate these billing irregularities to determine whether the matter is appropriate for enforcement under the False Claims Act.

United States Attorney Robert K. Hur commended the Office of Inspector General for the Department of Health and Human Services for its work in the investigation.  Mr. Hur also thanked Assistant United States Attorneys Thomas Corcoran and Neil White, who handled the case.