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Ageless Men's Health settles on billing allegations

AnaSCI

ADMINISTRATOR
Sep 17, 2003
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Memphis-based Ageless Men's Health LLC has settled with the U.S. government on allegations that it billed Medicare and Tricare for medically unnecessary evaluation and office visits while administering testosterone replacement therapy shots.

Ageless Men's Health will pay $1.6 million to settle the allegations, according to a release from U.S. Attorney's Office for the Western District of Tennessee.

Ageless operates testosterone replacement therapy clinics throughout the U.S. and has approximately 30 locations.

Under federal law, Medicare and Tricare reimburse medical providers only for procedures that are medically necessary.

In the case, the government contends that from 2009 through 2013, Ageless billed for a medically unnecessary office visit each time a testosterone shot was administered. The investigation was conducted by the U.S. Department of Health and Human Services Office of the Inspector General, the FBI and the Department of Defense Criminal Investigative Service.

The allegations were first raised in a lawsuit filed against the company under the qui tam, or whistleblower, provisions of the False Claims Act. The act allows private citizens with knowledge of fraud to bring civil actions on behalf of the government and to share in any recovery.

In addition to the $1.6 million payment, Ageless entered into an agreement with the DHS' Office of Inspector General that requires enhanced accountability and monitoring activities to be conducted by both internal and independent external reviewers.

"This settlement demonstrates our commitment to ensuring that Medicare and Tricare funds are not siphoned off by companies more concerned with bottom-line profits than legitimate patient care," U.S. Attorney Edward L. Stanton III said in the release. "Together with our law enforcement partners, we will continue to make enforcement of the False Claims Act a priority."

The claims settled were allegations only; there had been no determination of liability.

Assistant U.S. Attorneys Stuart Canale and William Siler prosecuted the case.