On Thursday, the U.S. District Court for the District of South Carolina entered default judgments for the United States totaling $136,025,077 against Oaktree Medical Centre P.C. (Oaktree), FirstChoice Healthcare P.C. (FirstChoice), Labsource LLC (Labsource), Pain Management Associates of the Carolinas LLC (PMA of the Carolinas) and Pain Management Associates of North Carolina P.C. (PMA of North Carolina). This is the second time the court has entered a default judgment in this matter. On July 20, 2020, the court entered a default judgment in the amount of $4,269,084.78 against ProLab LLC (ProLab) and ProCare Counseling Center LLC (ProCare). The court entered these judgments after these defendants failed to defend against the United States’ allegations.
In its complaint, filed on May 31, 2019, the United States alleged that Oaktree, FirstChoice, Labsource, PMA of the Carolinas and PMA of North Carolina — all of which were owned or operated by chiropractor Daniel McCollum — provided illegal financial incentives to providers to induce their referrals of urine drug tests in violation of the Stark Law and the Anti-Kickback Statute. The United States also alleged that ProCare, a substance abuse counseling clinic, and ProLab, a urine drug testing laboratory partially owned by McCollum, billed federal health care programs for unnecessary urine drug tests. McCollum answered the United States’ complaint and remains a party to the ongoing litigation.
Congress passed the Stark Law and the Anti-Kickback Statute to prevent financial incentives from improperly influencing medical decision-making, which can lead to excessive and unnecessary tests and services. Among other things, the Stark Law prohibits billing Medicare for laboratory testing services referred by a physician who has a financial relationship with the laboratory. The Anti‑Kickback Statute prohibits offering or paying anything of value to induce the referral of items or services covered by federal health care programs, including laboratory testing services.
“Improper financial relationships between health care providers and laboratories can lead to overutilization and increase the cost of health care services paid for by the taxpayers,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “We will continue to ensure that health care decisions are based on the needs of patients rather than the financial interests of providers.”
“Patients should not have to question whether their doctor recommended a test or procedure for personal gain,” said Acting U.S. Attorney M. Rhett DeHart for the District of South Carolina. “For years, these companies used improper financial incentives to generate health care provider referrals. This $140 million judgment is a cautionary tale of why health care fraud does not pay.”
The judgment includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Donna Rauch, Muriel Calhoun, Brandy Knight, Karen Mathewson and Tracy Hawkins, former employees of pain management clinics owned or operated by McCollum. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam cases are captioned United States ex rel. Rauch, et al. v. Oaktree Medical Centre, P.C., et al., No. 6:15-cv-01589-DCC (D.S.C.); United States ex rel. Mathewson v. Dr. Daniel A. McCollum, et al., No. 6:17-CV-01190-DCC (D.S.C.); and United States ex rel. Hawkins v. Pain Management Associates of the Carolinas, LLC, et al., No. 8:18-cv-02952-DCC (D.S.C.).
The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the District of South Carolina, with assistance from the FBI, the Department of Health and Human Service’s Office of Inspector General, the South Carolina Attorney General’s Office, and the Defense Criminal Investigative Service.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
The matter was handled by Fraud Section Attorneys Yolonda Campbell, Michael Kass, Christopher Terranova, and David Wiseman, along with Assistant U.S. Attorney Beth Warren of the District of South Carolina.