A Dallas dermatopathologist and his clinic were sued Monday by the federal government, which accused them of submitting nearly $4.2 million in fraudulent claims.
The civil False Claims Act complaint alleges that Dr. Clay Cockerell, 64, and his business, Cockerell Dermatopathology, falsely billed the government for medically unnecessary tests through TRICARE, the health insurance plan for military personnel, retirees and their families.
Among other devious practices, the suit alleges, a management company affiliated with the clinic handed out $50 Walmart gift cards to TRICARE beneficiaries who agreed to provide urine and saliva samples. These samples were then used for costly, needless laboratory tests.
The complaint says that in March 2015, Cockerell signed an agreement that allowed the management company, Progen, to use his clinic’s license to submit claims for payment for toxicological and other medical tests. Progen in return agreed to pay the clinic 20% of the net revenue from those tests.
Dermatopathology is the branch of medicine focused on the study of cutaneous diseases at a microscopic and molecular level, and on the analysis of the potential causes of skin diseases.
In an attempt to avoid the reach of the federal anti-kickback statute, the suit says, Cockerell specified that no testing services were to be provided to beneficiaries of TRICARE, Medicare, Medicaid or other federal health insurance programs.
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 the enterprise was violating the federal False Claims Act.
Despite these and other red flags, the complaint alleges, Cockerell continued to permit Progen to use his clinic to submit fraudulent claims to TRICARE.
The case was assigned to U.S. District Judge Jane Boyle. Assistant U.S. Attorney Richard Guiltinan is representing the government. Court records do not yet list an attorney representing Cockerell.