ASHLAND, Ky. – The U.S. Attorney’s Office has filed a civil
lawsuit against an Ashland addiction treatment specialist, Dr. Rose O. Uradu,
and her substance abuse treatment center, Ultimate Care Medical Services, LLC
d/b/a Ultimate Treatment Center, alleging that they defrauded the both Medicare
and Medicaid programs, and that they violated the Controlled Substances Act.
The lawsuit alleges that the defendants sought and received
payments from Medicare and Medicaid for services that were not actually
provided to patients. According to the
complaint, between January 2013 and September 2014, defendants billed these
government programs for “evaluation and management” services purportedly
provided to patients who visited the clinic to receive daily methadone doses
for their substance abuse treatment.
Evaluation and management services typically include performance of an
examination of the patient, a patient history, and medical
decision-making. The complaint alleges
that Ultimate Treatment Center did not perform these services when patients
received their methadone doses, but billed Medicare and Medicaid for the
services anyway. According to the
complaint, defendants falsely documented the performance of evaluation and
management services in the patients’ medical records, including by
electronically copying notes from one visit to the next – for days, weeks, and
even months.
The complaint further alleges that during the period July
2013 to December 2014, defendants billed Medicare and Medicaid for complex
urine drug testing that was not actually performed.
The lawsuit contends that billing for services not provided
violates the False Claims Act. If found
liable, the defendants will have to repay Medicare and Medicaid three times the
amount of the Government’s loss for the fraud, in addition to financial
penalties of $5,500 to $11,000 per false claim.
According to the complaint, the Government’s loss exceeds $1 million.
The lawsuit also alleges that, for a three-month period in
2014, Dr. Uradu issued buprenorphine prescriptions to twice as many patients as
is permitted by law. Buprenorphine is
marketed under the brand names Suboxone and Subutex, and is used medically in
the treatment of opioid addiction.
Because buprenorphine has the potential for diversion and abuse by
recreational users, it is a controlled substance regulated by law. According to the complaint, Dr. Uradu was
only permitted to treat 100 patients with buprenorphine drug products, but
repeatedly exceeded her patient limit.
Specifically, the complaint alleges that three months in a row, she
wrote prescriptions for buprenorphine for more than 200 unique patients – twice
her limit. The complaint contends that
Dr. Uradu violated the Controlled Substances Act each time she wrote a
prescription over her limit. Under that
law, if found liable, Dr. Uradu is subject to a financial penalty of up to
$25,000 for each violation.
Finally, the complaint further alleges that during the
period January 1, 2017 to April 28, 2017, Ultimate Treatment Center failed to
maintain complete and accurate records of the clinic’s methadone and
buprenorphine inventories, as is required by law. According to the complaint, Ultimate
Treatment Center’s records did not account for the equivalent of 45 bottles of
methadone oral solution, and 22 bottles of buprenorphine tablets. The complaint contends that Ultimate
Treatment Center’s failure to keep accurate records violates the Controlled
Substances Act. Under that law, Ultimate
Treatment Center is subject to a financial penalty of up to $10,000 for each
recordkeeping violation.
The lawsuit is captioned United States v. Rose O. Uradu, M.D.,
et al., Civ. No. 18-66. The
investigation preceding the complaint was conducted by agents with the U.S.
Drug Enforcement Administration, Federal Bureau of Investigation, and the
Kentucky Attorney General’s Medicaid Fraud and Abuse Control Unit. Assistant U.S. Attorney Christine Corndorf
will represent the United States in this case.
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