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John Durham, the United States Attorney for the District of Connecticut, announced that World Health Clinicians, its CEO Scott Gretz and a former practicing physician, Gary Blick, have entered into a civil settlement agreement with federal and state governments to pay $650,830 to resolve allegations that they violated federal and state false claims acts.
According to Durham, World Health Clinicians specializes in the treatment of HIV, AIDS patients and sexually transmitted infections. Blick was employed at the clinic from its inception in 2011 until he left in 2016. The government alleges that for several years, Blick and Gretz submitted false claims to the Medicare and Medicaid programs by billing for physical therapy services and certain office visit services that were not provided.
As alleged, Medicare and Medicaid patients being treated by World Health Clinicians received massages provided by a massage therapist. Those services were billed to Medicare and Medicaid as if the patients had, in fact, received physical therapy services and office visit services.
“Medicare does not recognize massage therapists as providers and expressly prohibits massage therapists from enrolling in the Medicare program,” according to Durham. “Under Connecticut law, massage therapists may not provide physical therapy, as physical therapy is expressly excluded from a massage therapist’s scope of practice. In addition, a massage therapist is not qualified to provide office visit services.”
“We expect that medical practices and physicians who participate in federal health care programs will bill for their services accurately and honestly,” he said in a statement. “The U.S. Attorney’s office in Connecticut is committed to vigorously pursuing health care providers who submit false claims to federal health care programs.”
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