The Massachusetts Attorney General’s Office has filed a whistleblower lawsuit against a chain of opioid addiction treatment centers and its former owner alleging the company billed Medicaid millions of dollars for medically unnecessary lab tests, violated federal anti-kickback and self-referral laws, and exposed countless patients to serious medical harm, among other allegations.
The Attorney General’s Office filed the complaint Oct. 16 in a Massachusetts federal court under the whistleblower provisions of the False Claims Act. The lawsuit accuses CleanSlate Centers and former company owner, Dr. Amanda Louise Wilson, of exploiting the national opioid epidemic with a scheme to build and operate a chain of for-profit “addiction-treatment centers,” described by their own employees as a “pill mill” where physicians are expected to “rubber stamp” stacks of prescriptions.
According to the whistleblower lawsuit, CleanSlate’s primary focus “is distributing buprenorphine-based drugs to as many opioid-addicted patients as possible.” These treatments are then followed by months and even years of automatic and unnecessary urine tests that were performed in labs that Dr. Wilson owned or managed.
CleanSlate’s clinical assessments, diagnoses, and treatments are drafted by non-physicians and implemented “without individualized decision-making by inadequately trained and supervised call center employees, nurse practitioners and physician assistants,” the complaint alleges. Many of the doctors employed by CleanSlate are under-qualified, part-time professionals hired not for their decision-making abilities but for their “potential to prescribe buprenorphine prescriptions to the maximum number of patients allowed by law,” according to the lawsuit.
Additionally, many of the expensive and medically unnecessary urine tests CleanSlate billed to Medicaid were not used to inform treatments for patients and frequently were never reviewed, the lawsuit asserts, adding that the tests were used as “a major revenue and profit driver for CleanSlate’s national expansion.”
“Defendants’ claims to federal and state governments for laboratory testing services performed at CleanSlates’ laboratory are false and/or fraudulent because they violate self-referral and kickback prohibitions and are medically unnecessary in violation of core government health care rules,” the lawsuit alleges.
The whistleblower complaint also asserts that CleanSlate’s “reckless” practices exposed patients to “serious medical harm.”
Dr. Wendy Welch, who first filed the False Claims Act lawsuit in 2017, began working as CleanSlate’s Eastern Division Medical Director on Oct. 31, 2016. She resigned in December 2016 and left the company the following month. According to the complaint, Dr. Welch’s “review of CleanSlate’s patient charts identified numerous instances in which patients’ tests revealed dangerous combinations of drugs of abuse, indicative of significant relapse, without any change in care, or even any acknowledgment by the supervising CleanSlate medical professionals.”
Federal and state governments can intervene in False Claims Act lawsuits filed by relators, or whistleblowers, as the U.S. government and the state of Massachusetts did in this case. Whistleblowers whose False Claims Act lawsuits result in judgment or settlement are awarded up to 30% of the total recovery.
Dr. Welch is also pursuing claims of personal retaliation under the False Claims Act and state law provisions that prohibit employers from retaliating against employees who report fraud and other misconduct against government programs and agencies.
If you’re a whistleblower, we may be able to help
Beasley Allen has a Whistleblower Litigation Team in place to handle False Claims Act (FCA) claims. Due to our firm’s heavy involvement in whistleblower litigation, there was a definite need for the creation of a team specializing in whistleblower cases. Fraud against the federal government has been and continues to be a huge problem, involving many industries in this country, and is usually rampant in the wake of disasters requiring federal assistance, such as major hurricanes, the Deepwater Horizon oil spill, and, as we have seen in recent months, the coronavirus pandemic. We expect the amount of fraud against the government to increase greatly during the coming months.
As we have consistently stated, whistleblowers are the key to exposing corporate wrongdoing and government fraud. A person who has first-hand knowledge of fraud or other wrongdoing may have a whistleblower case. Before you report suspected fraud or other wrongdoing – before you “blow the whistle” – it is important to make sure you have a valid claim and that you are prepared for what lies ahead. Beasley Allen’s group of lawyers dedicated to handling whistleblower cases can navigate you the oftentimes risky and complex litigation.
Lawyers on our whistleblower litigation team are Lance Gould, Larry Golston, Lauren Miles, Leon Hampton, Paul Evans and Tyner Helms. If you are aware of fraud being committed against the federal or state governments, you could be rewarded for reporting the fraud. If you have any questions about whether you qualify as a whistleblower, you can contact a lawyer at Beasley Allen for a free and confidential evaluation of your claim.