Poplar Healthcare to Pay Nearly $900,000 to Resolve A False Claims Act Allegations
PROVIDENCE, RI – Acting United States Attorney Stephen G. Dambruch and Philip Coyne, Special Agent-in-Charge of the Boston Office of Inspector General for the Department of Health and Human Services (HHS-OIG), today announced that Poplar Healthcare PLLC, and Poplar Healthcare Management, LLC (“Poplar”), of Memphis, TN, have entered into a civil settlement agreement with the United States, under which Poplar will pay $897,640 to resolve allegations under the federal False Claims Act. The government alleges that Poplar, directly and through a subsidiary known as GI Pathology, promoted and billed the government for diagnostic tests that the government contends were not medically necessary.
An investigation by the HHS-OIG and the United States Attorney’s Office for the District of Rhode Island determined that these tests, known as immunohistochemical mast cell tryptase stains, were the subject of an extensive, multi-year promotional campaign designed to promote the use of the stain, claiming that Poplar could use the test to definitively diagnose a condition known as “mast cell enterocolitis.” The Government alleged that Poplar’s promotion of the test was not consistent with FDA approval requirements, and not supported by adequate scientific evidence.
“Federal funding for diagnostic tests and procedures is predicated on the principle that those tests are ordered because they are medically necessary and in the best interest of patients, and not on other, inappropriate factors.” said Acting U.S. Attorney Stephen G. Dambruch. “We will continue to take aggressive action to address situations where profit, rather than the best interests of patients, drives the decision to conduct and bill for medical tests.”
“Our agency will continue to aggressively investigate health care providers that bill Medicare for unnecessary services just to boost profits,” said Special Agent in Charge Phillip Coyne, U.S. Department of Health and Human Services Office of Inspector General. "And we will not tolerate abuse of the system for personal gain, which can undermine medical decision-making and the public's trust in the health profession."
The investigation that led to the settlement began after Gordon Wang, M.D., a pathologist formerly employed by Poplar, filed a complaint against the company on behalf of the United States in the U.S. District Court for the District of Rhode Island. Under the federal False Claims Act, a private individual who has uncovered fraud against the federal government may file a suit in federal court on behalf of the United States. If the United States is successful in resolving those claims, the individual who filed the complaint may receive a share of the recovery. Dr. Wang will receive $205,841 from the proceeds of the settlement.
The government’s case was handled by Assistant U.S. Attorneys Zachary A. Cunha and Bethany N. Wong, with the assistance of Trial Attorney Michael E. Shaheen of the Department of Justice’s Civil Division.
Jim Martin (401) 709-5357
on Twitter @USAO_RI
Tags: Healthcare Fraud