Two Texas Medical Practices to Pay More Than $500,000 to Resolve False Claims Act Liability for Fraudulently Billing Medicare for P-Stim Devices

SAN ANTONIO - U.S. Attorney Jaime Esparza for the Western District of Texas announced Wednesday, separate civil settlements totaling $513,168.10 to resolve allegations that two area medical practices violated the False Claims Act (“FCA”) by improperly billing Medicare for P-Stim devices. The U.S. Attorney’s Office for the Western District of Texas has now obtained more than $2 million related to improperly billed P-Stim devices since June 2021.

P-Stim is an electro-acupuncture device that is affixed behind a patient’s ear using an adhesive. Needles are inserted into the patient’s ear and affixed using another adhesive. Once activated, the device provides intermittent stimulation by electrical pulses. It is a single-use, battery-powered device designed to be worn for approximately four days until its battery runs out, at which time the device is thrown away. Medicare does not reimburse for P-Stim devices.

Alamo City Pain Consultants LLC, d/b/a The Institute for Functional Health, a San Antonio medical practice, billed Medicare for P-Stim devices between May 2018 and January 2020.  Ronald Moore, DNP, Theresa Lambert, DNP, through their Austin area business entities Psych Dimensions Inc., and Lambert & Moore Enterprises Inc., billed Medicare for P-Stim devices to beneficiaries between December 2018 and March 2019.  The United States alleged that the medical practices fraudulently obtained payment from Medicare by falsely claiming they had implanted neuro-stimulators, a surgical procedure that usually requires an operating room and is reimbursable by federal healthcare programs.

Under the terms of the separate settlement agreements in these cases, Institute for Functional Health has agreed to pay $357,913.18 and Moore and Lambert have agreed to pay $155,254.92 to resolve their respective liability under the FCA for these claims. 

The settled civil claims are allegations only and do not constitute admissions of liability by the settling parties.

These matters were investigated by the U.S. Department of Health and Human Services Office of the Inspector General.  Assistant U.S. Attorney Erin M. Van De Walle negotiated the settlements on behalf of the United States.

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