United States Reaches $1.2 Million Civil Settlement with Festus Pain Management Doctor Over Allegations of False Claims to Federal Health Care Programs

ST. LOUIS – The United States Attorney’s Office for the Eastern District of Missouri announced today that the United States has reached a civil settlement to resolve allegations that Dr. Nehal Modh and Modh’s company knowingly submitted false claims to Medicare and Missouri Medicaid.

Dr. Modh is the president and sole owner of Progressive Pain Management in Festus, Missouri.  
The settlement announced today resolves allegations that Dr. Modh and PPM falsely indicated to both Medicare and Missouri Medicaid that ultrasound guidance was used on certain pain management injections, submitted false claims for payment for facet joint injections that did not meet billing substantiation requirements, and improperly coded claims for payment to receive excess reimbursement.

As part of the settlement, Dr. Modh and PPM will repay the United States $1.2 million, consisting of $600,000 in restitution doubled under the False Claims Act (FCA).  

The settlement resolves allegations brought under the qui tam or whistleblower provisions of the FCA by Donna Chronister, a former employee of PPM. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of the recovery.  The qui tam case is captioned United States ex rel. Donna Chronister v. Progressive Pain Management, P.C., et al, case no. 4:19-cv-2245 in U.S. District Court in St. Louis.  Chronister will receive $177,707 of the proceeds from the settlement. 

“We thank the whistleblower for her courage to bring her concerns forward,” said U.S. Attorney Sayler A. Fleming for the Eastern District of Missouri. “This settlement is an example of our important civil enforcement efforts where we work with whistleblowers to protect the public fisc.”  

"Health care fraud is a serious problem that costs taxpayers millions in wasted dollars while often depriving vulnerable beneficiaries of the care and support they need," said Special Agent in Charge Linda T. Hanley from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). "We will continue to aggressively investigate these cases in an effort to eliminate the corruption in our health care system."

This civil settlement was a result of the combined work of the U.S. Attorney’s Office for the Eastern District of Missouri, HHS-OIG’s Office of Investigations and Office of Audit, the Missouri Attorney General’s Medicaid Fraud Control Unit and the FBI.