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Chiropractor and his Practice Management Company Agree to Voluntary Exclusion

On January 23, 2018, Matthew Anderson and PMC Management Company, LLC (PMC), Tennessee, agreed to be excluded from participation in all Federal health care programs for a period of 5 years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that Anderson and PMC caused pharmacies to submit requests for payment to Part D Plan Sponsors and TennCare for medications, including controlled substances that were not dispensed for a legitimate medical purpose and/or that were dispensed without obtaining valid prescriptions under Tennessee law. OIG also alleged that Anderson and PMC submitted, or caused the submission of claims to Medicare that were : (1) coded with CPT code 99214 and modifier -25 when those claims were not payable as such; and (2) provided by a nurse practitioner who was not collaborating with a physician as required by Tennessee law. Senior Counsel Andrea Treese Berlin represented OIG.

Action Details

  • Date:January 23, 2018
  • Enforcement Types:
    • CMP and Affirmative Exclusions