March 24, 2021

According to allegations in a civil complaint filed Monday, Dr. Clay Cockerell, 64, knowingly permitted a laboratory management company to use his clinic’s lab license to submit false claims to federal health insurance programs, including TRICARE, for medically unnecessary tests.

The complaint alleges that in March 2015, Dr. Cockerell signed an agreement that authorized the management company, Progen, to use CDP’s CLIA lab license to submit claims for payment for toxicology and pharmacogenomic tests.  In return, Progen agreed to pay CDP twenty percent of the net revenue from those tests.

In an attempt to avoid the reach of the federal Anti-Kickback Statue (AKS), Dr. Cockerell specified that CDP would not provide any testing services to beneficiaries of federal health insurance programs, such as TRICARE, Medicare, or Medicaid, or collect any federal revenue.

According to the complaint, Dr. Cockerell quickly became aware that Progen was violating their agreement and submitting claims to federal healthcare programs. He also learned that Progen was engaged in gross mismanagement and abusive practices, and even received warnings that CDP was violating the False Claims Act.

Meanwhile, Progen marketers were offering $50 Wal-Mart gift cards to induce TRICARE beneficiaries to provide urine and saliva for expensive, medically unnecessary testing.

Despite these and other red flags, the complaint alleges that Dr. Cockerell continued to permit Progen, using CDP’s license, to submit fraudulent claims to TRICARE.

Read the full press release.

Source: Department of Justice

If you suspect Medicare fraud contact Ohio SMP at 1-800-488-6070 option 7, use the “Report Fraud” button on this App or click here.