PHILADELPHIA, PA — Federal prosecutors have filed a civil complaint under the False Claims Act alleging a scheme to improperly bill Medicare for treatments involving an electrical stimulation device and related injections, the U.S. Attorney’s Office for the Eastern District of Pennsylvania said.
The complaint names Dr. Michael Glickert and Dr. Joseph Novof of St. Louis, along with their clinic, The Vanguard Clinic LLC, and a related distributorship, Fleur de Lis LLC.
Prosecutors allege the defendants submitted or caused the submission of false claims to federal healthcare programs for treatments using the RST-Sanexas neoGEN-series device and associated vitamin injections.
Federal healthcare programs do not reimburse for electrical nerve stimulation treatments provided in outpatient clinics to treat pain or for vitamin injections administered in connection with those treatments, according to the complaint.
Authorities allege that beginning in late 2018, Glickert promoted the treatments as reimbursable by Medicare and provided billing guidance to other providers.
The complaint alleges Glickert knew the billing practices could be considered fraudulent but continued submitting claims.
Prosecutors also allege Novof falsely certified that vitamin injections were medically necessary despite not knowing their contents.
“Our office continues to lead the national charge to hold alleged fraudsters accountable for improper Sanexas billing,” U.S. Attorney David Metcalf said.
“We will continue working closely with our partners … to pursue any other providers who inappropriately billed for these devices and caused false claims to be submitted,” Metcalf said.
The case is part of a broader national investigation into billing practices involving electrical stimulation devices, which has resulted in multiple settlements and recoveries totaling millions of dollars, according to prosecutors.
The investigation involves coordination with the Department of Justice’s Civil Division, the Centers for Medicare & Medicaid Services, and the Department of Health and Human Services Office of Inspector General.
The allegations are part of a civil complaint, and no determination of liability has been made.
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