Kansas man to pay $15.2 million for national insurance fraud scheme

PHILADELPHIA (WIBW) – A Kansas man has been ordered to pay greater than $15.2 million for a nationwide insurance coverage fraud scheme.

The U.S. Lawyer’s Workplace for the Japanese District of Pennsylvania says that on Thursday, Nov. 3, the Honorable Mitchell S. Goldberg entered a default judgment towards Timothy Warren, of Wichita, and his firm Titan Medical Compliance, LLC. He was ordered to pay a complete of $15,270,066 for violations of the False Claims Act.

The Workplace famous that that is the most recent motion within the nationwide investigation right into a scheme of improper billing involving P-Stim electro-acupuncture units. P-Stim can be branded as ANSiStim, Stivax, NeuroStim, and NSS-2 Bridge. Federal healthcare packages don’t reimburse for these units.

As alleged within the grievance, Warren – a Wichita chiropractor – and his firm falsely promoted auricular electro-acupuncture units as reimbursable by Medicare and different federal insurers as authorised by the Meals and Drug Administration. He promoted himself as a medical reimbursement guide and his firm as a compliance consulting agency.

In consequence, the Workplace indicated that numerous entrepreneurs and distributors of P-Stim units paid Warren a month-to-month payment to supply coding suggestions to clients. Suppliers additionally paid him straight for coding steering.

Starting in 2014, courtroom data point out that Warren promoted the units as reimbursable and offered directions on what codes to invoice. These codes, which generated a excessive quantity of reimbursement, have been truly meant for reliable, surgically implanted neurostimulators to handle persistent ache. P-Stim alternatively may very well be utilized in a couple of minutes in an workplace setting with out anesthesia and minimal coaching.

Throughout this time, the Workplace additionally mentioned that Warren and his firm did actually know that the P-Stim units weren’t reimbursable by federal healthcare packages, however continued to advertise the non-surgical units regardless.

The Workplace famous that it filed its grievance towards Warren on Oct. 14, 2021, and has litigated the case since then – together with defeating a movement by Warren to switch the case to the District of Kansas. The U.S. moved for default judgment after Warren’s counsel withdrew and the defendants failed to reply.

In keeping with the judgment, Warren and Titan are actually chargeable for penalties that whole $15.2 million for inflicting about 1,200 claims to be falsely submitted to the federal healthcare packages in violation of the FCA.

“This workplace has led the nationwide cost to carry people and entities chargeable for P-Stim fraud,” mentioned U.S. Lawyer Romero. “With Warren’s judgment, our workplace has held accountable these chargeable for the contaminated claims paid by federal healthcare packages. Even those that by no means utilized P-Stim themselves may be held accountable for inflicting others to submit false claims by means of advertising and disseminating fraudulent coding recommendation.” She continued with a warning to different suppliers and medical machine entrepreneurs: “If a scheme appears too good to be true, it most likely is—and you ought to be cautious.”

For extra details about the judgment, click on HERE.

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