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False Claims Allegations Lead To Big Payouts Ahead Of The Holidays

The holiday season is generally a joyous occasion for most people. It’s a time for giving and sharing memorable moments with loved ones. There are some, however, who would rather take than give. Far be it from us to assume that Santa Claus will be filling the stockings of such individuals with coal. But there are some people who are certainly paying the price for their misdeeds ahead of Christmas Day.

Philadelphia pharmacy owner agrees to pay $1 million to resolve False Claims Act liability.

Bachtu “Theresa” M. Phan is a pharmacist and owner of LAN Apothecary in Philadelphia, Pennsylvania. As reported by the Eastern District of Pennsylvania branch of the United States Department of Justice this week, she and her pharmacy will jointly pay $1 million to the federal government. The payment is to resolve allegations that they violated the False Claims Act. It is alleged that Phan and the pharmacy billed Medicare for prescription medications that were not actually dispensed.

The violation of the False Claims Act is alleged to have taken place between January 1, 2014 and June 29, 2019. Among the drugs listed in the prescriptions were Januvia, Janumet, Zetia, Tradjenta, Linzess, Advair Diskus, Namenda XR, and Dexilant. In addition to the settlement, both Phan and LAN Apothecary will enter into a corporate integrity agreement with the Department of Health and Human Services, Office of the Inspector General.

According to the DoJ report, “the integrity agreement requires them to undertake substantial compliance obligations and to contract with an Independent Review Organization that will conduct quarterly third-party audits of their Medicare and Medicaid claims and drug inventory.”

Mississippi physician agrees to pay $375,000 to resolve False Claims Act allegations.

Dr. Kevin Cooper owns the family medical practice, Cooper Family Medical Center. It is based in Gulfport, Mississippi. This past Monday, the Southern District of Mississippi branch of the United States Department of Justice announced that Cooper and his clinic have agreed to pay $375,000 to resolve false claims allegations. It is alleged that they knowingly and improperly billed Medicare for acupuncture devices. This is in violation of the False Claims Act (“FCA”).

According to the DoJ report, Dr. Cooper and his clinic billed Medicare more than $900,000 over a one-year period. The claims were for non-reimbursable electro-acupuncture devices known as P-Stim. “P-Stim is an electro-acupuncture device that, pursuant to manufacturer’s instructions, is affixed behind a patient’s ear using an adhesive,” explains the DoJ, “Needles are inserted into the patient’s ear and affixed using another adhesive. Once activated, the device then provides intermittent stimulation by electrical pulses.”

It is alleged that the P-Stim devices were not surgically implanted despite Dr. Cooper using billing codes that indicated they were. Between July 2018 and August 2019, he routinely presented, or caused to be presented, false claims to Medicare. As a result, Dr. Cooper and his clinic received $179,106.72 from Medicare to which they were not entitled.

Are you an attorney who is currently working a health care fraud case?

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