Columbus Pain Clinic and Owner Agree to Pay $650,000 to Resolve Allegations of Unnecessary Procedures

The US DOJ announced on January 24, 2020 that “Comprehensive Pain Management Institute and its owner, Leon Margolin, M.D., have agreed to pay the United States $650,000 to resolve False Claims Act allegations that they knowingly billed Medicare for nerve conduction studies and alcohol/substance abuse assessments and interventions (SBIRT)” because they were either:

  • Not medically necessary
  • Not provided

Dr. Margolin is a pain management doctor in Columbus, Ohio.

Nerve conduction studies and electromyography studies, performed in unison, help identify the “presence and location of diseases that damage nerves and muscles.” Just conducting the nerve study test alone can be misleading and is considered not medically necessary – except in limited cases that did not apply in this False Claims Act case.

SBIRT is “an early intervention targeting those with substance abuse to provide effective strategies prior to the need for more extensive treatment.” The US DOJ claimed that Dr. Margolin and his clinic improperly billed Medicare for the nerve condition studies when it didn’t perform the corresponding electromyography. The SBIRT tests were not medically necessary because they were being performed on patients who didn’t have a history of alcohol or drug abuse or because the services that were billed – were not actually provided.

Submitting false claims to Medicare affects patient safety causes taxpayers to pay more than they should and affects the integrity of the healthcare sector.

If you know that a doctor or healthcare provider is billing for unnecessary tests or for procedures that are not required, you may have a valid whistleblower claim. Whistleblowers in False Claims Act cases may be entitled to up to 25% of any recovery. To prepare a strong whistleblower claim, call the experienced qui tam lawyers at the California Law Offices of Stephen A. Danz and Associates.

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