California Physician and Medical Practice Reach $3.8 Million False Claims Act Settlement
The Center for Health & Wellbeing and Dr. Janette Gray reached a $3.8 million settlement with the United States Attorney’s Office for the Southern District of California, resolving False Claims Act allegations.
Dr. Gray and the clinic portrayed themselves as an “alternative,” “integrative,” and “holistic” clinic, staffed by myriad health professionals, including medical doctors, nurse practitioners, naturopathic doctors, chiropractors, acupuncturists, and mental health professionals, along with ancillary medical and administrative staff. The Center and Dr. Gray promoted IV infusion therapy, hormone/supplement therapy, and a variety of other alternative treatments.
The government alleged that Gray and the Center for Health & Wellbeing in San Diego billed Medicare and TRICARE from 2012 to 2022 for services that were not covered under either program by misrepresenting the services provided to patients, disguising the provider rendering the services, billing for medically unnecessary services, and/or unbundling services. Unbundling services involves billing for a procedure or service in parts, instead of under a single code.
Included in the settlement is the requirement that Gray be excluded from participating in Medicare, Medicaid, and other federal health programs for five years. As we often see in these settlements, the claims resolved are allegations and there has been no determination of liability.
“The civil settlement holds Dr. Gray and her former medical practice accountable for questionable actions that circumvented the TRICARE billing guidelines and allowed them to receive payments for services that should not have been reimbursed by TRICARE, costing American taxpayers millions of dollars,” said Bryan D. Denny, Special Agent in Charge of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS), Western Field Office. “DCIS and its partners will always aggressively investigate those who defraud TRICARE, because those deceptive actions ultimately harm those defending our country and their families.”