At first glance, The Center for Health & Wellbeing seemed like a sanctuary for those seeking alternative treatments beyond conventional medicine. Patients sought a holistic approach to their wellness and received IV infusions, hormone therapies, and acupuncture all under the care of licensed physicians, nurse practitioners, naturopathic doctors, chiropractors, acupuncturists,  mental health professionals, and more. However, beneath this was a scheme to take advantage of government healthcare programs by submitting bills to Medicare and TRICARE for millions of dollars’ worth of uncovered services. The U.S. Attorney’s Office, Southern District of California recently announced the $3.8 million settlement for violating the False Claims Act.

According to the government, between 2012 and 2022, Dr. Janette J. Gray and her practice allegedly falsely billed Medicare and TRICARE for services that weren’t covered by either program by disguising the identity of the service providers, misrepresenting the nature of the treatments, “unbundling” services by billing separately for parts of a procedure instead of using a single code, and charging for many services that weren’t medically necessary.

As part of the settlement agreement, what seems like a lighter punishment for a detailed crime: Dr. Gray is barred from participating in Medicare, Medicaid, and other federal health care programs for a mere five years.

However, U.S. Attorney Tara McGrath makes it clear that the Justice Department does not take these charges lightly. “There’s no price tag on the integrity of our healthcare system,” said McGrath. “When a doctor engages in billing fraud, we will protect patients and taxpayers from deceit.”

Bryan D. Denny, Special Agent in Charge of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS), added, “The civil settlement holds Dr. Gray and her former medical practice accountable for questionable actions…  DCIS and its partners will always aggressively investigate those who defraud TRICARE, because those deceptive actions ultimately harm those defending our country and their families.”

FBI San Diego Acting Special Agent in Charge Houtan Moshrefi also acknowledged the agency’s commitment stating,“This investigation is proof that the FBI and its law enforcement partners remain committed to investigating and bringing to justice anyone who tries to violate the American healthcare system.”

Whistleblowers play a key role in uncovering misconduct similar to this case. If you have any information of Healthcare Fraud that directly impacts Medicare/Medicaid and would like to speak to an experienced member of the Constantine Cannon whistleblower lawyer team, please do not hesitate to reach out and contact us for a free and confidential consultation.

Read San Diego Holistic Physician and Medical Practice Agree to Pay $3.8 Million to Resolve False Claims Act Allegations at constantinecannon.com