Grants Pass Physician and Affiliated Practice Paying $115,000 for Fraud Allegations
GRANTS PASS PHYSICIAN AND AFFILIATED MEDICAL PRACTICE AGREE TO PAY $115,000 TO SETTLE HEALTH CARE FRAUD ALLEGATIONS
December 19th, 2023
PORTLAND, Ore.—A Grants Pass, Oregon medical doctor and his general medical practice have paid $115,000 to settle allegations by the United States regarding the physician, on behalf of himself and his practice, submitting medical reimbursement claims to Medicare, TRICARE, and the Veterans Health Administration (VHA), announced the U.S. Attorney’s Office for the District of Oregon.
Wendell Heidinger, 60, and Optimal Health of Southern Oregon, LLC (Optimal), paid $115,000 to the United States.
The United States contended that, between January 1, 2018, and December 31, 2020, Dr. Heidinger and Optimal submitted claims for reimbursement to Medicare, TRICARE, and VHA coded as “evaluation and management” when frequency specific microcurrent (FSM) treatments were primarily provided. Medicare considers FSM as an investigational treatment for which it does not provide coverage or payment.
Medicare is a public health insurance program administered by the Centers for Medicare & Medicaid Services, a federal agency within the U.S. Department of Health and Human Services (HHS). TRICARE is a civilian health care program administered by the Defense Health Agency (DHA), a joint, integrated combat support agency within the U.S. Department of Defense (DOD). VHA, an agency within the U.S. Department of Veterans Affairs, is the largest integrated health care system in the United States and provides primary care, specialized care, and related medical and social support services to American veterans.
This settlement was the result of a coordinated investigation by the U.S. Attorney’s Office for the District of Oregon; HHS Office of Inspector General (HHS-OIG); and DHA.
The United States was represented in this matter by Carla G. McClurg, Assistant U.S. Attorney for the District of Oregon, with assistance from Lisa M. Re, Assistant Inspector General for Legal Affairs for HHS-OIG and Salvatore M. Maida, General Counsel for DHA.
The claims resolved by this settlement are allegations only, and there has been no determination or admission of liability.