Comprehensive Pain Specialists is one of the biggest pain management chains in the country – with 60 offices in 11 states. State Senator Steve Dickerson is the founder of the company. The business shut down a year ago, leaving many patients without their medical records and searching for new doctors.
According to a report in The Tennesseean, Sen. Dickerson is working with federal investigators regarding fraud in his pain management practice. The US Department of Justice is investigating Comprehensive Pain Specialists (CPS) for potential “widespread fraud,” including:
- Providing drug tests that were unnecessary
- Dishonest billing
- Forging documents
According to The Tennessean, prosecutors will be filing a lawsuit which “is expected to consolidate allegations raised by at least 7 whistleblowers who came forward about the company in the past three years.” The former CEO of CPS was convicted for taking bribes. Sen. Dickerson testified at that trial, claiming he knew nothing about what the former CEO was doing.
The basics of a False Claims Act case
The lawsuit filed by prosecutors will fall under the False Claim Act (FCA). An FCA lawsuit is normally started by a whistleblower, though it can be brought directly by the Department of Justice. Claims involve two key elements: some element of fraud and the involvement of a federal agency. Typically, medical fraud claims brought through the FCA are based on Medicare or Medicaid fraud. The focus of the claim is to force the defendant to return any payments that were improperly paid by Medicare, Medicaid, or any other federal agency. FCA claims usually also involve treble damages, statutory fines, interest, and legal fees. While the goal of an FCA case is payment of money, the charges are criminal in nature. Defendants can also be sentenced if they are found guilty of an FCA violation.
There are defenses. Claims under the False Claims Act must follow specific procedures. For example, the claim must be under seal. In additional to procedural defenses, defendants do have the right to show the bills they submitted were justified. There may be Constitutional defenses. Defendants don’t have to give evidence against themselves. The Department of Justice must normally obtain a warrant to search a business. Defendants ultimately have the right to question and cross-examine the witnesses who are accusing them of fraud in court.
At Delius & McKenzie, PLLC we have been fighting for defendants for more than 20 years. We represent defendants accused of fraud and a full range of other offenses. Our Sevierville defense lawyers work aggressively to have charges dismissed, to negotiate fair plea agreements, and to obtain acquittals. We represent defendants throughout Tennessee, including Bristol, Gatlinburg, Johnson City, Kingsport, Pigeon Forge, Sevierville, Greeneville and Seymour.