Clarksville Pain Management Clinic and Managers Agree to Pay $1.5 Million to Resolve False Claims Act Allegations Involving Medically Unnecessary Testing

NASHVILLE - Two companies that operated a Clarksville-based pain management clinic and two of their managers have agreed to pay $1.5 million to resolve allegations that they violated the False Claims Act by submitting, or causing the submission of, false claims to Medicare and the Department of Veterans Affairs (VA) for medically unnecessary diagnostic testing, announced United States Attorney Braden H. Boucek for the Middle District of Tennessee.

The settlement resolves allegations against Clarksville Pain Institute, LLC; Pain Institute of Nashville, PLC; Michael Cox; and Debbie Cox. According to a complaint filed by the United States on September 11, 2024, the defendants allegedly submitted, or caused to be submitted, false claims to Medicare and the VA for medically unnecessary urine drug testing, allergy testing, and psychological testing between April 2014 and May 2024.

Clarksville Pain Institute operated a pain management clinic with its primary location in Clarksville, Tennessee, and additional locations in White House and Springfield, Tennessee. The clinic merged with Pain Institute of Nashville in 2018. Michael Cox and Debbie Cox held various management positions with both entities, and Debbie Cox held an ownership interest in both.

"Federal health care programs exist to provide necessary medical care, not to generate payments for unnecessary testing," said U.S. Attorney Boucek. "When providers allegedly misuse these programs for financial gain, they undermine public trust and divert taxpayer dollars from legitimate patient care. Our office will continue working with our federal partners to protect the integrity of these programs and hold those who submit false claims accountable."

Under the terms of the settlement, the defendants will collectively pay $1.5 million to the United States.

The settlement also resolves a whistleblower lawsuit filed by Krista Nicholson, a former employee, under the qui tam provisions of the False Claims Act. These provisions allow private individuals to file lawsuits on behalf of the United States and share in any resulting recovery. Nicholson will receive $285,000 as her share of the settlement.

The claims resolved by the settlement are allegations only, and there has been no determination of liability.

The matter was investigated by the U.S. Attorney's Office for the Middle District of Tennessee, the Department of Health and Human Services Office of Inspector General (HHS-OIG), and the Department of Veterans Affairs Office of Inspector General (VA-OIG). Assistant United States Attorney Wynn M. Shuford represented the United States.

The civil action is captioned United States ex rel. Nicholson v. Clarksville Pain Institute, et al., Case No. 3:20-cv-00309 (M.D. Tenn.).

####