According to the Memphis Business Journal, Ageless Men’s Health, LLC, based in Tennessee, has agreed to settle allegations that it violated the False Claims Act. Ageless Men’s Health, LLC (“Ageless”) operates more than two dozen testosterone replacement therapy clinics across the Unites States. According to the Ageless website, it currently maintains clinics in Arizona, California, Colorado, Georgia, Illinois, Mississippi, Nevada, New York, Tennessee, Texas, and Utah. The Memphis Business Journal reported that the False Claims Act allegations relate to the submission of invoices for patient evaluation and office visits while patients were receiving testosterone replacement therapy injections.
The allegations were first raised in a whistleblower lawsuit filed in 2013 under the qui tam provisions of the False Claims Act. According to the complaint filed in the U.S. District Court for the Western District of Tennessee, the whistleblowers are former employees of the Ageless’s Oak Court location in Memphis. Whistleblower Robert Booth was a physician’s assistant and Wanda Scallorn was employed by Ageless in its accounts receivable department.
The government alleged that, between 2009 to 2013, Ageless submitted claims to Medicare and TRICARE (the health program for the U.S. military) for a medically unnecessary office visit each time a patient received a testosterone injection. Government health care programs such as Medicare and TRICARE will only pay medical practitioners for treatments and procedures that are medically necessary.
The whistleblowers alleged in their complaint that Ageless upcoded the visits to increase the amount that could be billed to Medicare and TRICARE by $40 per visit. The whistleblowers claimed this resulted in the receipt of improper revenues by Ageless in the amount of $2,912,000 over the four years. The whistleblowers contended that each submission of an upcoded invoice to the government was a violation of the False Claims Act.
The U.S. Attorney’s Office for the Western District of Tennessee stated that Ageless agreed to pay $1.6 million in settlement of the False Claims Act allegations. In addition, Ageless agreed to be bound by a corporate integrity agreement. The whistleblowers may be entitled to share in a percentage of the settlement proceeds as their reward under the qui tam provisions of the False Claims Act.