Chattanooga Provider Settles Allegations Of Improper Billing For Electro-Acupuncture Devices

KNOXVILLE, Tenn. - The United States Attorney's Office announced today that Apple Corporate Wellness, Inc., now known as Bryn Medical Center and Basket Medical PLLC (collectively "Apple"), agreed to pay $1,148,598 to resolve allegations that it knowingly and improperly billed Medicare for electro-acupuncture using auricular stimulation devices in violation of the False Claims Act ("FCA").

Apple was an outpatient clinic located in Chattanooga, Tennessee that offered medical and chiropractic services for the treatment of pain. According to the settlement agreement, the United States contends that for dates of service between June 28, 2016, and June 19, 2017, Apple presented, or caused to be presented, to Medicare false claims for payment for the placement of electro-acupuncture devices on patients. The placement of these devices was improperly billed using Healthcare Common Procedure Coding System ("HCPCS") Code L8679, which resulted in Apple receiving payments from Medicare to which it was not entitled.

HCPCS Code L8679 is a billing code for "implantable neurostimulator, pulse generator" devices that are surgically implanted into the central nervous system or targeted peripheral nerves through procedures that are typically performed by a surgeon in an operating room. However, the United States contends that Apple falsely billed Medicare using HCPCS Code L8679 for electro-acupuncture devices it knew were not surgically implanted into their patients and for procedures that did not involve anesthesia or take place in an operating room. The underlying services for which Apple submitted the HCPCS Code L8679 claims involved application of a device used for electro-acupuncture. The electro-acupuncture devices were applied by inserting needles into patients' ears and by taping the devices behind their ears with an adhesive. Medicare does not reimburse for electro-acupuncture devices billed as neurostimulators and did not reimburse for acupuncture during the period of the covered conduct.

This investigation resulted from a coordinated effort between the U.S. Attorney's Office for the Eastern District of Tennessee, the Office of Inspector General of the U.S. Department of Health and Human Services, and the Southeastern Unified Program Integrity Contractor.

Assistant U.S. Attorney Joseph C. Rodriguez represented the United States.

The claims settled by this agreement are allegations only, and there has been no determination of liability.

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