Southeastern Physical Therapy And Owner To Pay $152,000 To Settle False Claims Allegations For Submitting
Claims For Medically Unnecessary Durable Medical Equipment To Veterans Administration
ASHEVILLE, N.C (STL.News) U.S. Attorney Andrew Murray announced today that Asheville-based Southeastern Physical Therapy (SEPT) and owner Darren Cady have agreed to resolve allegations that Cady received illegal kickbacks and violated the False Claims Act by submitting claims for reimbursement for certain durable medical equipment to the Veterans Administration (VA) while participating in the VA “Choice Provider” program.
The Veterans Access, Choice, and Accountability Act of 2014 provided veterans with expanded access to third-party providers outside the VA system. In 2018, the program was replaced by the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (“Mission Act”). The Mission Act provided for the same access to third-party providers. Under the 2014 Act and the Mission Act, veterans could use third-party providers like SEPT for certain services. Provider participation in the program was memorialized in contracts with third-party administrators. The contracts required providers to comply with applicable local, State, and federal laws, rules, regulations and institutional and professional standards of care.
The United States alleges that, among other things, SEPT and Cady made materially false, fictitious, and fraudulent statements and representations, or material omissions, regarding the medical necessity of a medical device and received illegal kickbacks from the device manufacturer for prescribing the devices to VA patients.