CVR Management, LLC and related entities agreed on Mar. 20 to pay the United States $4 million to settle allegations that they violated the False Claims Act by billing Medicare, Medicaid, and TRICARE for medically unnecessary vein treatment procedures.
The settlement addresses concerns about improper billing practices in the health care system and aims to reinforce public trust in federal health insurance programs.
According to the U.S. Attorney for the District of Maryland Kelly O. Hayes, CVR Management, along with Center for Vein Restoration, Center for Vascular Medicine (CVM), LLC, and Sanjiv Lakhanpal, MD, FACS, submitted claims over a six-year period for chronic venous insufficiency treatments that were not clinically indicated or medically necessary. The government alleges these procedures included sclerotherapy, radiofrequency ablation, and endovenous laser ablation between January 1, 2010 and December 31, 2016. "Billing for medically unnecessary procedures saps public confidence in the health care system and is a drain on the public fisc," Hayes said. "We will hold accountable health care providers that knowingly engage in such conduct."
Special Agent in Charge Maureen Dixon of HHS-OIG said: "The Medicare and Medicaid programs cover medically necessary procedures, and health care providers are required to submit accurate claims for the services provided. HHS-OIG will continue to work with the U.S. Attorney’s Office and additional law enforcement partners to evaluate and pursue allegations of inaccurate billings to federal health insurance programs." Christopher Dillard of DCIS added: "This settlement demonstrates DCIS’s commitment to collaborate with its investigative partners to hold fraudulent providers accountable. DCIS will continue to safeguard the military community and aggressively work to help maintain public trust in TRICARE, the DoD’s primary health care program."
CVR Management operates multiple vein treatment centers across Maryland through its management of Center for Vein Restoration and Center for Vascular Medicine practices; these entities specialize in diagnosing and treating vein disease as well as deep venous and arterial disorders.
Of the $4 million civil settlement, $3,395,634.93 represents the federal share while $604,365.07 is allocated as total Medicaid recovery among eight states plus Washington D.C., with state Medicaid programs jointly funded by federal and state governments.
The case also resolves whistleblower lawsuits filed under qui tam provisions by former employees Karen Fulton and Jane Doe; they will receive $752,000 from the settlement proceeds.
Hayes commended investigators from HHS-OIG and DCIS/DODIG as well as Assistant U.S. Attorneys Tarra DeShields and Roann Nichols who handled this case.
The United States emphasized its ongoing efforts against healthcare fraud using tools like the False Claims Act but noted that all resolved claims are allegations only without determination of liability.
