Williamsburg chiropractic clinic owners agree to pay over $650,000 to settle improper billing claim

The owners of a Chiropractic clinic in Williamsburg have agreed to pay over $650,000 to settle government claims that it improperly billed Medicare and Medicaid.

The U.S. Attorney’s Office for the Eastern District of Kentucky, the Office of Inspector General of the Department of Health and Human Services (HHSOIG) and the Kentucky Attorney General’s Office jointly announced last week that the owners of Ho Medical Clinic, Kenneth Ho and Ana Moreno agreed to pay the U.S. Government $656,000. According to the settlement agreement, the clinic improperly billed the government programs for diagnostic and physical therapy services from February of 2003 through February 2009.

A former Ho Medical employee sued the company using the qui tam provision of the False Claims Act, informally known as "whistleblowing." The False Claims Act is a federal law that allows individuals to file lawsuits against anyone who defrauds U.S. Government programs. If the U.S. receives money as a result of the whistleblower’s lawsuit then the plaintiff(s) (the whistleblower) may receive a portion of the recovered money. In this case, the plaintiff, Danette Freeman, will receive $131,000 of the recovered money and an additional $11,400 from Ho and Moreno representing attorney fees. The other $525,000 of the settlement money will be sent back to the Medicare and Medicaid trust fund.

The complaint alleged that Ho and Moreno submitted false claims to Medicare and Medicaid by:

• Billing for services not actually rendered;

• Billing for physician services when, in reality, primary services were performed by a chiropractor;

• Billing for physical therapy services for work performed by unqualified personnel;

• Billing for unnecessary and unreasonable MRI and X-ray services and;

• Receiving fund for being a rural Health Clinic, when in reality Ho Medical did not meet Medicare requirements.

According to the agreement, Ho and Moreno have 15 days from the time it is effective to pay the settlement.

The investigation was conducted by the Kentucky Attorney General’s Office, the Department of Health and Human Services and the U.S. Attorney’s Office. Assistant U.S. Attorney Andrew Sparks handled the litigation on behalf of the U.S. Attorney’s Office.