NORWALK MEDICAL PRACTICE, CEO AND PHYSICAN PAY $650,830 TO SETTLE FALSE CLAIMS ACT ALLEGATIONS
John H. Durham, United States Attorney for the District of Connecticut, today announced that WORLD HEALTH CLINICIANS, INC. (“WHC”), its Chief Executive Officer, SCOTT GRETZ, and a physician formerly employed by WHC, DR. GARY BLICK, have entered into a civil settlement agreement with the federal and state governments in which they will pay $650,830 to resolve allegations that they violated the federal and state False Claims Acts.
WHC is a medical practice located in Norwalk specializing in the treatment of HIV/AIDS patients and sexually transmitted infections. GRETZ is the CEO of WHC. BLICK worked at WHC from the inception of the practice in 2011, until he left the practice in 2016. Prior to working at WHC, BLICK had his own medical practice specializing in the treatment of HIV/AIDS patients.
The government alleges that WHC, BLICK and GRETZ submitted false claims to the Medicare and Medicaid programs by billing for physical therapy services and certain office visit services that were not provided. Instead of receiving physical therapy or office visit services, Medicare and Medicaid patients seen at the practice received massages provided by a massage therapist. Those services were billed to Medicare and Medicaid as if the patients had, in fact, received physical therapy services and office visit services.
Medicare does not recognize massage therapists as providers and expressly prohibits massage therapists from enrolling in the Medicare program. Under Connecticut law, massage therapists may not provide physical therapy, as physical therapy is expressly excluded from a massage therapist’s scope of practice. In addition, a massage therapist is not qualified to provide office visit services.
To resolve the allegations under the federal and state False Claims Acts, WHC, BLICK and GRETZ have agreed to pay $650,830, which covers conduct occurring from January 1, 2007, through September 30, 2015. Pursuant to their agreement with the government, WHC and GRETZ will pay $361,013.77 and BLICK will pay $289,816.23.
“We expect that medical practices and physicians who participate in federal health care programs will bill for their services accurately and honestly,” said U.S. Attorney Durham. “The U.S. Attorney’s office in Connecticut is committed to vigorously pursuing health care providers who submit false claims to federal health care programs.”
This matter was investigated by the Office of Inspector General for the Department of Health and Human Services. The case is being prosecuted by Assistant U.S. Attorney Richard M. Molot and by Assistant Attorney General Gregory O’Connell of the Connecticut Office of the Attorney General.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.
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