U.S. Attorney Robert J. Troester | U.S. Department of Justice
The United States and the State of Oklahoma have initiated legal proceedings under the federal False Claims Act and the Oklahoma Medicaid False Claims Act against Coordinated Care Health Solutions, LLC, operating as HunterCare Coordinated Care Health Solutions (CCHS), and its laboratory director, Eric P. Wallis, Ph.D. The complaint accuses them of submitting false or fraudulent claims for payment to various Government Health Benefit Programs for testing services that were either not provided or not eligible for reimbursement.
The affected programs include Medicare, Oklahoma Medicaid, TRICARE health plan, Civilian Health and Medical Programs of the VA, and the Federal Employees Health Benefits Program. The complaint details that CCHS allegedly conducted laboratory testing services ordered by third-party practitioners to monitor and treat patients. During this period, Wallis was employed as a laboratory director at CCHS.
From November 2018 through 2021, it is alleged that CCHS and Wallis misrepresented non-reimbursable urine drug tests as blood tests to bypass Oklahoma Medicaid’s prior authorization requirement for definitive urine drug testing services. They are accused of submitting claims to Oklahoma Medicaid that misrepresented the services performed.
Additionally, the complaint alleges systematic billing to federal agency Government Programs for presumptive urine drug testing that was not rendered. It asserts that Wallis caused these claims' submission despite knowing there was no medical purpose for reporting "presumptive results" which were not used in treating program beneficiaries.
Further allegations state that from November 2018 through January 2023, CCHS billed Government Programs for medically unnecessary definitive urine drug testing services. These tests were reportedly ordered or billed through impermissible blanket directives or were not medically reasonable or necessary.
The complaint claims that due to these actions, Government Programs paid millions of dollars for thousands of false claims. The United States and Oklahoma seek damages with trebling provisions and penalties for each false claim submitted by the defendants.
This case is being managed by the U.S. Attorney’s Office for the Western District of Oklahoma along with assistance from multiple investigative bodies including the Department of Health and Human Services Office of Inspector General among others.
The case is titled U.S. et al. v. Coordinated Care Health Solutions, LLC d/b/a HunterCare Coordinated Care Health Solutions et al., No. CIV-24-1185-JD (W.D. Okla.). It should be noted that these are allegations only; no liability has been determined yet.
