Jacksonville Health Care Provider Physicians Group Services Agrees to Pay $700,000 to Resolve Civil Health Care Fraud Allegations | USAO-MDFL

Tampa, Fla. – United States Attorney Roger B. Handberg today announced that Physicians Group Services, PA (“PGS”) has agreed to pay the United States and the State of Florida $700,000 for resolve allegations that PGS violated the False Claims Act by submitting false or fraudulent claims to the Florida Medicaid program, which is a state and federal partnership that provides access to health care coverage for low-income families and individuals in Florida.

The US investigation focused on urine drug testing (“UDT”) by PGS. UDT occurs in a variety of health care settings. In a pain management practice, the UDT is used to monitor whether a patient is taking prescribed medications, taking non-prescribed medications, or consuming with prescribed medications other hazardous substances, such as alcohol. The UDT is either “qualitative” or “quantitative”.

The clinical value of the quantitative UDT depends in part on whether the qualitative result of the UDT is expected or unexpected, as well as the patient’s history of substance abuse, history of medication compliance and compliance, presentation clinic and medical history. The settlement announced today resolves allegations that PGS submitted requests to Florida Medicaid for quantitative urine drug testing, alleging that the United States and the State of Florida were medically unnecessary because the tests were not individualized to the specific needs of the patient.

“One of the primary missions of the United States Attorney’s Office is to protect the Medicaid program and other federal health care programs from fraud,” said U.S. Attorney Roger Handberg. “Our Civil Division works tirelessly to prosecute providers who overcharge federal health care programs through blind testing.”

“Health care providers who submit fraudulent Medicaid claims for medically unnecessary services are undermining this safety net program for their own personal gain,” said Special Agent in Charge Omar Pérez Aybar of the Inspector General’s Office. from the US Department of Health and Human Services. continue to work tirelessly with our law enforcement partners to protect the integrity of federal health care programs and to ensure the proper use of US taxpayer dollars.

Attorney General Ashley Moody said, “My Medicaid Fraud Enforcement Unit is committed to ending the fraud that defrauds the Medicaid program and benefits our taxpayers. I am proud of my Medicaid Fraud Control Unit for working with our federal partners to secure this action.

Today’s settlement is the result of a coordinated effort by the U.S. Attorney’s Office for the Intermediate District of Florida, the Department of Health and Human Services Inspector General’s Office, and the Fraud Enforcement Unit Florida Attorney General’s Medicaid. Assistant United States Attorneys Lindsay Saxe Griffin and Sean Keefe led the civilian investigation.

The claims resolved by the settlement are allegations only and no liability has been determined.