United States Files Suit Against Pain Institute of Nashville, Michael Cox, Debbie Cox, and Related Entities

NASHVILLE - The United States today filed a complaint in intervention alleging violations of the False Claims Act by Clarksville Pain Institute, LLC, Pain Institute of Nashville, PLC, Michael Cox, and Debbie Cox, announced Acting U.S. Attorney Thomas J. Jaworski for the Middle District of Tennessee. The complaint also includes the common law claims of unjust enrichment and payment by mistake.

As set forth in detail in the 70-page complaint, since at least 2014, these pain clinics and the Coxes violated the False Claims Act by knowingly submitting or causing to be submitted false claims for diagnostic testing services provided to patients that were not medically necessary, including urine drug screens, allergy tests, and psychological tests.

The complaint alleges that the defendants pressured staff at their Clarksville pain management clinic to bill for more testing than was medically necessary, that the practice routinely tested patients' urine and did not review the results, and that the practice operated multiple schemes to maximize testing profits from different kinds of diagnostic testing. Moreover, the complaint alleges that the defendants ignored multiple warnings from consultants, auditors, and insurers that their billing practices did not comport with Medicare requirements. Furthermore, the complaint alleges that patients described being treated like cattle at the clinic, spending minutes with providers, and receiving unnecessary testing that was pushed on patients if they wanted to receive their pain medications.

The government began investigating the wrongdoing alleged in today's complaint in response to a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery.

The matter is being investigated by the Department of Health and Human Services, Office of Inspector General, and the Department of Veterans Affairs, Office of Inspector General. Assistant U.S. Attorney Michael Tackeff represents the United States.

The claims alleged by the United States are allegations only, and there has been no determination of liability. The lawsuit is captioned United States ex. rel. Krista Nicholson, et al. v. Clarksville Pain Institute, LLC, et al., Case No. 3:20-cv-00309 (M.D. Tenn.).

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