On February 4, 2015, the U.S. Attorney’s Office announced that Ageless Men’s Health LLC (AMH), a testosterone replacement clinic, headquartered in Memphis, TN, agreed to pay the government $1.6 million to resolve allegations that it violated the False Claim Act (FCA) by overbilling the government for medically unnecessary procedures and office visits.  AMH operates over 30 men’s health clinics throughout the United States.

Federal law requires that medical provider’s bill Medicare and Tricare only for procedures that are medically necessary.  According to the qui tam lawsuit filed on behalf of the government, from 2009 to 2013 AMH allegedly billed Medicare and Tricare for the cost of office visits each time a testosterone shot was administered.  Although testosterone treatments are covered by Medicare and Tricare, AMH allegedly knowingly billed Medicare and Tricare for testosterone replacement shots that were not considered medically necessary and violated the FCA.

As part of the $1.6 million settlement, and to avoid exclusion from participation in Medicare, Medicaid, or other Federal health care programs, AMH entered into a Corporate Integrity Agreement (CIA) with the Department of Health and Human Services (DHHS).  This agreement requires enhanced accountability and monitoring activities to be conducted by both internal and independent external reviewers.  The agreement typically lasts 5 years is designed to deter future wrongful conduct.

If you have information concerning a potential case involving Medicare fraud or Government Health Care billing for medically unnecessary procedures, do not hesitate to take action. It is possible that you might be able to bring your own qui tam lawsuit under the False Claims Act, acting as a whistleblower on behalf of the US government. The act allows private citizens with knowledge of fraud to bring civil actions on behalf of the government and to share in any recovery.  Before filing your lawsuit, be sure to consult with an attorney familiar with the intricacies of the False Claims Act and qui tam lawsuits, as these attorneys are best equipped to help protect your rights and help you gain your share of any monetary reward from a potential settlement.