Philly Leader

Florida-based Electrostim Medical Services, Inc. (EMSI) and its Founder and Chairman Mario Garcia, Jr. have agreed to pay $20 million to resolve allegations of violating the False Claims Act. The allegations involve billing federal healthcare programs for excessive and medically unnecessary supplies related to Transcutaneous Electrical Nerve Stimulation (TENS) devices.

TENS units are used for short-term pain relief by delivering a low-voltage electrical current to the skin around an affected area. Necessary supplies include electrodes and rechargeable batteries, which require occasional replacement for extended use. In some cases, wearable garments containing electrodes may be prescribed instead of traditional electrodes.

When a TENS device is prescribed for home use, suppliers like EMSI provide patients with a device kit that includes all necessary supplies for about one month. Federal healthcare programs vary in reimbursement methods: Medicare uses a "bundled" supply code allowing monthly billing at a fixed rate, while TRICARE permits itemized billing using "unbundled" codes.

The government alleges that from 2018 through 2019, EMSI and Garcia marketed TENS devices primarily to TRICARE beneficiaries and billed improperly for replacement supplies during the first month when initial kits already contained necessary items. They also allegedly billed monthly resupplies of traditional electrodes alongside garments, despite knowing these were not needed simultaneously.

U.S. Attorney Jacqueline C. Romero stated: “Durable medical equipment suppliers play a vital role in providing safe and effective medical devices to patients in need, and especially to our brave service members and their families... This conduct will not be tolerated by my office.”

Acting Special Agent in Charge Brian J. Solecki from the Defense Criminal Investigative Service (DCIS) Northeast Field Office added: “Protecting the integrity of TRICARE is a top priority of DCIS... We will continue to work with the U.S. Attorney’s Office and our law enforcement partners to ensure that individuals who engage in fraudulent activity... are held accountable.”

Syreeta Scott from the U.S. Department of Labor's Office of Inspector General emphasized their commitment: “The U.S. Department of Labor, Office of Inspector General remains committed... to investigate allegations involving medical provider billing schemes that target programs administered by the U.S. Department of Labor.”

This resolution concludes an investigation by agents from DCIS, DOL-OIG, OPM-OIG, USPS-OIG, and VA-OIG.

Assistant United States Attorneys Charlene Keller Fullmer, Bryan C. Hughes, former Assistant United States Attorney John T. Crutchlow handled the civil investigation and settlement with assistance from Auditor George Niedzwicki.

The claims asserted by the United States are allegations only; there has been no determination of liability.