Health Care Management Corporation Agrees to Pay $4 Million to Resolve False Claims Act Allegations

Baltimore, Maryland - CVR Management, LLC, a professional services corporation in Greenbelt, Maryland, along with the Center for Vein Restoration, Center for Vascular Medicine (CVM), LLC, and Sanjiv Lakhanpal, MD, FACS, agreed to pay the United States $4 million to resolve allegations that they violated the False Claims Act by billing Medicare, Medicaid, and TRICARE for medically unnecessary vein treatment procedures.

Kelly O. Hayes, U.S. Attorney for the District of Maryland, announced the settlement with Special Agent in Charge Maureen Dixon, Department of Health and Human Services Office of Inspector General (HHS-OIG), and Christopher Dillard, Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS) - Mid-Atlantic Field Office.

According to the United States, CVR, over a six-year period, knowingly submitted claims to Medicare, Medicaid, and TRICARE for chronic venous insufficiency treatment procedures that were medically unnecessary. Specifically, the government alleges that chronic venous insufficiency can be treated by sclerotherapy, radiofrequency ablation, or endovenous laser ablation. The condition refers to the improper functioning of the vein valves where blood, which normally should move upwards toward the heart, instead pools in the veins such that the walls of the veins weaken and become distended manifesting as varicose veins, cramping, swelling, or skin discoloration on the affected leg and sometimes as ulcers or skin necrosis on the legs.

The United States further alleges that neither Medicare, Medicaid, nor TRICARE cover the treatment of varicose veins for cosmetic reasons alone. Treatment for chronic venous insufficiency must be accompanied by certain other conditions and after the patient undergoes a specified period of alternative treatment options that prove unsuccessful. Between January 1, 2010, and December 31, 2016, CVR knowingly billed Medicare, Medicaid, and TRICARE for sclerotherapy, radiofrequency ablation, and endovenous laser ablation procedures that were not clinically indicated and were medically unnecessary.

"Billing for medically unnecessary procedures saps public confidence in the health care system and is a drain on the public fisc," Hayes said. "We will hold accountable health care providers that knowingly engage in such conduct."

"The Medicare and Medicaid programs cover medically necessary procedures, and health care providers are required to submit accurate claims for the services provided," Dixon said. "HHS-OIG will continue to work with the U.S. Attorney's Office and additional law enforcement partners to evaluate and pursue allegations of inaccurate billings to federal health insurance programs."

"This settlement demonstrates DCIS's commitment to collaborate with its investigative partners to hold fraudulent providers accountable," Dillard said. "DCIS will continue to safeguard the military community and aggressively work to help maintain public trust in TRICARE, the DoD's primary health care program."

CVR Management, LLC provides health care management services and manages the operations of the Center for Vein Restoration, a multi-state collection of physician-led vein treatment practices and medical centers specializing in diagnosing and treating vein disease, notably chronic venous insufficiency and varicose veins. It operates 16 locations in Maryland. The Center for Vascular Medicine, a related practice group, specializes in the treatment of deep venous and arterial disorders in the legs, feet, and pelvic areas. CVM operates several offices located in Maryland, Virginia, and North Carolina. Lakhanpal is the entities' CEO and president and CVM's chairman of the board.

The federal share of the civil settlement is $3,395,634.93. Additionally, the total Medicaid recovery is $604,365.07, with eight Medicaid participating states, and the District of Columbia, slated to receive $325,208.84 of the civil settlement and the United States $279,156.23 of the Medicaid recovery. State Medicaid programs are jointly funded by the federal and state governments.

This civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Karen Fulton and Jane Doe, both former employees of CVR. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The relators' share of the proceeds of the settlement will be $752,000. The qui tam actions are captioned U.S. ex rel. Fulton v. CVR Management, LLC, et al., No. 15-cv-3591 (D. Md.) and U.S. ex rel. Jane Doe v. Center for Vein Restoration, LLC, et al., No. 20-cv-1943 (D. Md.), respectively.

U.S. Attorney Hayes commended the HHS-OIG and DCIS/DODIG for their work in the investigation. Ms. Hayes also thanked Assistant U.S. Attorneys Tarra DeShields and Roann Nichols who handled this case, along with Investigator Ann Thiel.

The United States' settlement in this matter illustrates the government's emphasis on combating health care 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 claims resolved by this settlement are allegations only and there has been no determination of liability.

For more information about the Maryland U.S. Attorney's Office, its priorities, and resources available to report fraud, please visit justice.gov/usao-md and justice.gov/usao-md/report-fraud.

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