A local physician and her former practice in San Diego, The Center for Health & Wellbeing, have agreed to pay a hefty fine of $3.8 million following accusations of submitting false claims to Medicare and TRICARE. The U.S. Attorney’s Office announced this settlement, which addresses allegations spanning from 2012 to 2022.
Dr. Janette J. Gray’s clinic, which promoted itself as an “alternative,” “integrative,” and “holistic” medical facility, employed various medical professionals who specialized in treatments like IV infusion therapy and hormone/supplement therapy. However, investigators revealed that Dr. Gray and her practice were involved in fraudulent billing practices, including misrepresenting services provided, disguising the rendering provider, and billing for unnecessary treatments.
In addition to the financial penalty, Dr. Gray will be prohibited from participating in Medicare, Medicaid, and all federal health care programs for the next five years. U.S. Attorney Tara McGrath stressed the importance of maintaining integrity in healthcare and vowed to safeguard patients and taxpayers from deception.
The Department of Defense’s Office of Inspector General also took notice of the case, pointing out the financial impact of the alleged fraud on TRICARE billing guidelines. Special Agent in Charge Bryan D. Denny highlighted that the civil settlement holds Dr. Gray and her former practice accountable for actions that cost American taxpayers millions of dollars.
FBI San Diego Acting Special Agent in Charge Houtan Moshrefi reiterated the commitment to combatting healthcare fraud and highlighted the collaborative efforts of law enforcement agencies in addressing violations within the healthcare system. The settlement was the result of a joint effort involving multiple agencies, including the U.S. Attorney’s Office for the Southern District of California, the Department of Health and Human Services, DCIS, and the FBI, with Assistant U.S. Attorney Maritsa A. Flaherty leading the case.
Although the allegations resolved through the settlement remain unproven, the case underscores the government’s continuous fight against healthcare fraud. Individuals are encouraged to report any suspected fraud or abuse to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477). Healthcare fraud not only impacts the financial system but also jeopardizes patient care and trust in the medical profession. It is crucial for healthcare providers to uphold ethical standards and adhere to billing regulations to ensure the well-being of patients and the integrity of the healthcare system.
