Tampa Physician To Pay $24.5M To Settle Unnecessary Testing Claims

WASHINGTON, D.C. — Physician Partners of America LLC, headquartered at 501 N Reo St., Tampa, its founder, Rodolfo Gari, and its former chief medical officer, Dr. Abraham Rivera, have agreed to pay $24.5 million to resolve allegations that they violated the False Claims Act by billing federal health care programs for unnecessary medical testing and services.

Physicians Partners is also accused of making unlawful payments to doctors it employed and making a false statement about a loan obtained through the Small Business Administration’s Paycheck Protection Program.

Other Physician Parnters affiliates are also liable for the settlement amount, including the Florida Pain Relief Group, the Texas Pain Relief Group, Physician Partners of America CRNA Holdings LLC, Medical Tox Labs LLC and Medical DNA Labs LLC.

The U.S. Department of Justice accused Physicians Partners of making claims for medically unnecessary urine drug tests by requiring its physician employees to order multiple tests at the same time without determining whether any testing was necessary and without reviewing the results of initial testing.

Physician Partner’s affiliated toxicology lab then billed federal health care programs for the highest-level of urine test.

In addition, the company encouraged its physicians to order presumptive urine tests by paying them 40 percent of the profits from the testing, which is against the law.

The DOJ also accused the company of requiring patients to submit to genetic and psychological testing before they were seen by physicians without determining if there was a need.

The company then billed federal health care programs for the tests.

When Florida suspended all nonemergency medical procedures to reduce the transmission of COVID-19 in March 2020, the DOJ said Physicians Partners tried to make up the lost revenue by having its physicians schedule unnecessary evaluations and management appointments with patients every 14 days, instead of every month, as was previously required.

The doctors were then told to bill these visits using a high-level procedure code that didn't match the tests run.

While small businesses laid off employees and permanently closed their doors because they were unable to qualify for a federal PPP loan, Physicians Partners lied to the Small Business Administration to qualify for a $5.9 million PPP loan, according to the DOJ.

“Billing federal health care programs for services that providers know are unnecessary or unreasonable undermines the quality of care that patients receive and increases the costs of these taxpayer-funded programs,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department is committed to ensuring that health care providers base their treatment decisions on their patients’ needs rather than their own financial interests.”

“Holding health care providers accountable for inflated claims and false statements helps ensure the integrity of the health care system as a whole,” said U.S. Attorney Roger B. Handberg for the Middle District of Florida. “Settlements like this one are an important step in that direction.”

“Since the beginning of the pandemic, the SBA has been focused on providing relief swiftly, equitably and efficiently to millions of struggling small business owners. Ensuring that relief has been distributed with the utmost integrity has been central to that mission under Administrator Guzman,” said SBA general counsel Peggy Delinois Hamilton. “The SBA takes fraud seriously and will continue to make it our priority to work alongside the Office of the Inspector General to identify and address any potential fraud to ensure sound administration of relief programs.”