The United States Department of Justice and the United States Attorney’s Office Middle District of Tennessee announced that Franklin-based Rinova The Wellness Group, PC, has settled allegations of fraudulent operations of former pain MD clinics.
U.S. Attorney for the Middle District of Tennessee Don Cochran announced the settlement in a May 20 press release that alleged that Medicare overpaid Rinova for claims that were non-payable due to fraudulent misrepresentation.
The government specifically alleged that Rinova misrepresented that it had provided services, when they were actually a continuation of services by the suspended company Pain MD, LLC.
At that time, Medicare contractors had suspended all payments to Pain MD, based on what the government called credible allegations of fraud.
Rinova then obtained new Medicare payment numbers, which according to the United States, amounted to an attempt to evade the Medicare payment suspension of Pain MD, so that Rinova could obtain Medicare reimbursements while operating Pain MD’s Tennessee and Virginia pain clinics, all while using the same Pain MD employees, patients, clinics and locations.
In June of 2019 the Medicare contractor suspended payments to Rinova and in September of 2019 Rinova’s billing privileges were revoked, and Rinova no longer operates any pain clinics in Tennessee or throughout the country.
According to the release, the settlement resolves the government’s claims that it overpaid Rinova for all of its services, and under the settlement agreement, Rinova waived its claim to $379,961 in suspended Medicare payments, forfeited $49,112, and paid an additional $53,151, for a total value of $482,224.
The investigation was also aided by the Tennessee Bureau of Investigation's Medicaid Fraud Control Unit, the Department of Health and Human Services and the Office of Inspector General. Assistant U.S. Attorney Ellen Bowden McIntyre represented the United States in the case.