(This post was written by whistleblower attorney Shelby Serig.)
As most Americans are well aware, our nation is in the midst of a destructive opioid epidemic. This scourge has harmed communities, destroyed lives, and exhausted the public’s resources. While government agencies struggle to contain the disaster, reckless drug manufacturers, distributors, dispensers, and prescribers have profited. As the epidemic wears on, opportunists have found new (but equally harmful) ways to fleece government payers, namely submitting false claims for reimbursement under the guise of addiction treatment. Patients in pain are preyed upon by unscrupulous fraudsters, and when they become addicted to these dangerous drugs and eventually seek help, they are victimized yet again.
Just this week, Kentucky addiction rehabilitation specialist Dr. Rose O. Uradu and her facility, Ultimate Treatment Center, agreed to pay $1.4 million for allegedly violating the Controlled Substances Act and defrauding Medicare and Kentucky Medicaid. Ultimate Treatment Center purportedly received payments from those programs for services that were not actually rendered to patients. For example, the defendants allegedly billed for “evaluation and management” services in connection with providing methadone treatment to addicts. To be reimbursed by Medicare and Kentucky Medicaid, those services must include a patient examination, patient history and medical decision-making. However, according to the settlement, none of these steps occurred at Ultimate Treatment Center. In reality, the defendants are said to have recklessly dispensed methadone, itself an addictive narcotic, when the medication was not medically indicated. The defendants then allegedly submitted false documentation to government payers, claiming that appropriate examination and diagnosis had occurred prior to dispensing drugs. The purported wrongful acts did not stop there. From July 2013 to December 2014, the defendants allegedly billed Medicare and Kentucky Medicaid for complex urine drug testing that the clinic’s equipment was incapable of performing. Furthermore, Uradu in 2014 reportedly prescribed buprenorphine, a controlled substance, to more patients than permitted by law.
The government funded these “treatments” in the hopes of rehabilitating opioid addicts. Unfortunately, the drugs dispensed by Ultimate Treatment Center were often abused by recreational users, further harming communities and families. Such schemes cannot be stopped without the help of law-abiding citizens willing to blow the whistle on fraudulent activities. As we strive to curb the opioid epidemic, we must remain ever vigilant to the new versions of fraud, waste, and abuse that will pop up in the addiction treatment sector.
Morgan & Morgan takes pride in representing whistleblowers who choose to stand up against cheaters and fraudsters. We strongly encourage prospective whistleblowers to obtain counsel to assist them in filing their complaints. Healthcare rules and regulations can be difficult to understand and challenging to navigate. If we move forward with your claim, our team of experienced lawyers and investigators will be with you through the entire process, from the initial filing to the ultimate resolution. Our work is always done on a contingency basis, which means we get paid only if we win your case. If you know of a company that has committed fraud against a government program, reach out to us. All calls and information shared is treated confidentially.