Baltimore Doctor To Pay $436K To US Over False Claims Act Allegations Related To Performing Medically Unnecessary Procedures
BALTIMORE (WJZ) -- A Baltimore doctor must pay $436,000 to the United States to settle False Claim Act allegations related to performing "medically unnecessary procedures," over a period of four years.
Dr. Ebezener Quainoo, M.D., an internist in the city who operates a medical practice known as Baltimore Health Care, P.C., agreed to pay to settle the allegations that he made claims to Medicare for "medically unnecessary autonomic nervous function tests and trigger point injections using ultrasound guidance between July 2014 to November 2018.
The United States alleged that autonomic nervous function tests were not medically necessary because Dr. Quainoo lacked the necessary equipment to conduct the tests, the patients did not have an autonomic nervous function disorder before the test was conducted, Dr. Quainoo lacked the specific training to conduct such tests, and he only used the tests to monitor patient symptoms, not make any clinical decisions about future patient care.
Autonomic nervous function disorders are uncommon disorders typically, and tests are only meant to be used after a clinician suspects an autonomic nervous function disorder and only one time per person, with the right eqipment and only by clinicians with the specialized training to do so, the announcement noted.
Trigger point injections are meant to treat patients with localized muscle pain in places with "palpable and painful knots or nodules," but only when non-invasion medical management, such as muscle relaxers, physical therapy, or other treatments don't work.
The U.S. also alleged these procedures, specifically the trigger point injections, were not medically necessary because he had failed to exhaust conservative treatments or therapy before doing the procedures, and ultrasound guidance wasn't needed to perform the injections.