PRESS RELEASE: US and State of OK file False Claims Act complaint against OKC laboratory and director


The United States Department of Justice sends this information as posted below:


OKLAHOMA CITY – The United States and the State of Oklahoma filed a complaint under the federal False Claims Act and the Oklahoma Medicaid False Claims Act against Coordinated Care Health Solutions, LLC d/b/a HunterCare Coordinated Care Health Solutions (CCHS) and Eric P. Wallis, Ph.D., for submitting or causing the submission of false and/or fraudulent claims for payment to certain Government Health Benefit Programs (Government Programs) for testing services that were not rendered or not reimbursable. The Government Programs harmed by the alleged conduct are Medicare, Oklahoma Medicaid, the TRICARE health plan, the Civilian Health and Medical Programs of the VA, and the Federal Employees Health Benefits Program.

The complaint alleges CCHS purports to perform laboratory testing services ordered by third-party practitioners to monitor and treat patients. During the time relevant to the complaint, Wallis was employed by CCHS as its laboratory director. He was a management official, directed CCHS’s laboratory operations, and supervised the laboratory employees, including the CCHS billing supervisor.

The complaint alleges that from at least November 2018 through 2021, CCHS and Wallis disguised non-reimbursable urine drug tests as blood tests to by-pass Oklahoma Medicaid’s prior authorization requirement for definitive urine drug testing services. The complaint alleges CCHS submitted, and Wallis caused the submission of, claims for payment to Oklahoma Medicaid that misrepresented the services performed and included services that were not rendered.

The complaint also alleges CCHS systematically billed the federal agency Government Programs for presumptive urine drug testing that was not rendered, and that Wallis caused the submission of these claims. Defendants knew or should have known there was no medical purpose to report “presumptive results” and that those results were not used in the treatment of program beneficiaries. The claims were submitted to the Government Programs for payment for presumptive testing anyway and violated the False Claims Act.

The complaint further alleges that, from at least November 2018 through January 2023, CCHS routinely billed the federal agency Government Programs for medically unnecessary definitive urine drug testing services, and Wallis caused the submission of these claims. These tests were ordered and/or billed through impermissible blanket directives, were not ordered at all, and/or were not medically reasonable and necessary for the treatment of program beneficiaries.

The complaint alleges that, as a result of Defendants’ conduct, the Government Programs paid millions of dollars for thousands of false and/or fraudulent claims for non-reimbursable testing services. The United States and the State of Oklahoma seek to recover damages, along with appropriate trebling of those damages, and penalties for each false claim submitted or caused to be submitted by Defendants.

This matter is being handled by the U.S. Attorney’s Office for the Western District of Oklahoma and the Oklahoma Attorney General’s Medicaid Fraud Control Unit. The Department of Health and Human Services Office of Inspector General, the Department of Health and Human Services Office of Inspector General Office of Audit Services, Qlarant (the CMS Unified Program Integrity Coordinator for the Southwestern Jurisdiction), the Defense Criminal Investigative Service, the Department of Veterans Affairs Office of Inspector General Criminal Investigations Division, and the Office of Personnel Management Office of Inspector General provided substantial assistance in the investigation.

The case is U.S. et al. v. Coordinated Care Health Solutions, LLC, d/b/a HunterCare Coordinated Care Health Solutions et al., No. CIV-24-1185-JD (W.D. Okla.).

The claims asserted in this action are allegations only and there has been no determination of liability.


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