By: Richard L. Smith
Amid an ongoing investigation into fraudulent healthcare practices, a South Jersey pain management company has admitted to over billing insurance providers for services not properly rendered or supervised. 
According to a statement released by the U.S. Department of Justice, Pain Specialists, P.A., which operates clinics in Northfield, Vineland, and Cape May Courthouse, pleaded guilty to healthcare fraud in federal court.
The announcement was made by U.S. Attorney John Giordano, who confirmed that the company entered the plea before U.S. District Judge Karen M. Williams.
In addition to the guilty plea, Pain Specialists also entered into a civil settlement with the federal government to resolve additional claims under the False Claims Act.
Court documents and statements revealed that the clinic’s owner, identified as “Individual-1,” is a physician specializing in pain management and anesthesiology.
Between November 2015 and January 2020, while the physician was traveling and not on-site, the clinic billed Medicare, Medicaid, and private insurers for procedures using his National Provider Identifier (NPI) — falsely indicating his presence or supervision during those services.
The fraudulent billing resulted in the clinic receiving $58,365.26 in payments.
The civil settlement also addressed further misconduct between 2014 and 2020, when the clinic allegedly billed services under a physician’s name even though they were performed by non-physician practitioners without a supervising doctor present — violating both Medicare and Medicaid billing rules.
As part of the resolution, Pain Specialists agreed to pay $58,365.26 in restitution, an $81,711.36 criminal fine, and a $240,000 civil settlement.
Officials noted that the civil allegations remain unresolved in terms of liability.