Dr. Robert Burkich of Chattanooga and Preventive Medicine Anti-Aging & Chelation, Inc., his practice in Ringgold, have settled claims under the False Claims Act to resolve allegations that they knowingly submitted false claims to Medicare for medically unnecessary chelation therapy.
Dr. Burkich and his practice will jointly pay $700,000 to the United States to be used as restitution to Medicare.
“By falsely certifying that services provided to patients are medically necessary, healthcare providers deplete the resources available to Medicare beneficiaries who are actually in need of care,” said Acting U.S. Attorney Richard S. Moultrie, Jr. “In coordination with our law enforcement partners, our Office will continue to identify and pursue individuals who commit acts of waste, fraud, and abuse against the Medicare program.”
“Providers who knowingly submit unreasonable and medically unnecessary claims prioritize personal profits over their duty to patients and federal health care programs,” said Kelly J. Blackmon, special agent in charge of the U.S. Department of Health and Human Services Office of Inspector General. “HHS-OIG, in partnership with our law enforcement allies, remains committed to investigating fraudulent billing practices that undermine the integrity of federal health care programs and jeopardize the well-being of beneficiaries.”
“We must assure patients and taxpayers that the care provided by federally- funded healthcare programs is dictated by clinical needs, not fiscal greed,” said Paul Brown, special agent in charge of FBI Atlanta. “The FBI and our partners are committed to combining resources to investigate and hold providers accountable for billing the government only for necessary services.”
The United States alleges that between September 2009 and January 2017, Dr. Burkich billed Medicare for administering the chelation drug edetate calcium disodium to Medicare beneficiaries who were not suffering from lead poisoning. EDTA is a rarely used drug that is indicated for use only in individuals suffering from lead poisoning and lead encephalopathy.
Medicare has several long-standing rules preventing reimbursement for EDTA when not used for cases of lead poisoning or lead encephalopathy. The United States alleges that Dr. Burkich falsely represented to Medicare that his patients suffered from lead poisoning or other heavy-metal-related diseases to avoid Medicare’s restrictions and obtain reimbursement.
Based on these allegations, the U.S. Attorney’s Office for the Northern District of Georgia filed suit against Dr. Burkich and his practice, accusing them of violating the False Claims Act, 31 U.S.C. 3729, et seq. That statute prohibits, among other conduct, the knowing submission of false claims for payment to government agencies. The case is titled United States v. Burkich et al., No. 1:19-cv-03510-MLB (N.D. Ga.).
The settlement was reached under the Department of Justice’s ability-to-pay guidelines, which can be used to settle cases where defendants lack the financial ability to pay a merits-based settlement. The guidelines require defendants to submit to a rigorous financial analysis to determine their ability to pay a settlement.
This matter was litigated by Assistant U.S. Attorney Anthony DeCinque and former Assistant U.S. Attorney Paris Wynn.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.