Multiple whistleblower lawsuits filed against Comprehensive Pain Specialists and members of its leadership team — including State Sen. Steve Dickerson, R-Nashville — were unsealed this week, alleging a broad scheme to defraud Medicare through unneeded lab testing. The federal government has stepped in to prosecute the case.
The initial complaint in the master case of all the consolidated filings was submitted by former CPS employee Suzanne Alt, who worked as a physician at a CPS clinic in Missouri. She said CPS leaders forced providers to utilize costly drug screenings that were medically unnecessary solely for Medicare patients, then sent them to a CPS lab in Brentwood managed by CPS co-founder Peter Kroll for processing.
According to the complaint, CPS was billing for more than 600 drug screens per day — at times generating 80 percent of the company’s Medicare revenue.
Similar to a complaint against former CPS CEO John Davis — who was found guilty early this month of leading a kickback scheme — the Alt suit claims CPS leadership incentivized physicians to mandate these high-dollar drug screenings through a bonus system structured around lab revenue. The more they billed for the specific drug test, the more money they would receive.
When Alt questioned CPS leadership about the drug screening practice and offered various cost-efficient alternatives, she was fired.
All the cases, said Jerry Martin, former U.S. attorney and partner at Barrett Johnston, are seeking to recover money from CPS that it defrauded from the Medicare and Medicaid programs.
“Whistleblowers are vitally important to protecting the integrity of both Medicare and Medicaid. We are thankful that the U.S. Attorney’s Office diligently investigated the claims brought forth by the whistleblowers in these cases,” he said. “The DOJ lawyers and the HHS-OIG agents have clearly put in tremendous time and effort to protect the taxpayers. We look forward to continuing to work with them in this matter.”
After its closing, the lab in question apparently was taken over by InSite Surgical Partners, a company in Kroll’s name which listed the lab as its principal address until it dissolved mid-January.
Dickerson wasn’t individually identified in the initial complaint filed by Alt but was named as a defendant in other suits that have now been consolidated. He did, however, profit from the scheme and accepted campaign donations for his 2012 senate run from a shell company Davis set up as part of his kickback scheme.
The federal government has yet to file their complaint against CPS or other defendants.