Former Owners of a federal Health Clinic Pay $800,000 to the State of Tennessee Resolve Claims of Billing for more Medicaid Visits than Performed.
Barrett Johnston Martin & Garrison represented the former Chief Operating Officer in blowing the whistle on what was, at the time, the only Federally Qualified Health Clinic Look-Alike in the State of Tennessee. Under this FQHC look-alike program, qualifying clinics may take advantage of certain favorable billing rules in exchange for an agreement not to turn patients away based on an ability to pay. Amongst other allegations, our client alleged that the clinic, ProHealth Rural Health Services, defrauded the State of Tennessee by billing for more TennCare visits than the company actually performed. The State of Tennessee estimated its damages and penalties at approximately $18 million. While the company filed bankruptcy, the former owners agreed to pay the State of Tennessee $800,000 to resolve the claims asserted against them individually.
Read The State of Tennessee’s press release regarding the state’s intervention in the case.