The United States and the State of Oklahoma have initiated legal proceedings against Coordinated Care Health Solutions, LLC, operating as HunterCare Coordinated Care Health Solutions (CCHS), and its laboratory director, Eric P. Wallis, Ph.D. The lawsuit alleges that CCHS and Wallis submitted false or fraudulent claims to government health benefit programs for services not rendered or not eligible for reimbursement.
The complaint specifies that these alleged actions impacted several government programs, including Medicare, Oklahoma Medicaid, TRICARE, the Civilian Health and Medical Programs of the VA, and the Federal Employees Health Benefits Program. It claims that from November 2018 through 2021, CCHS disguised non-reimbursable urine drug tests as blood tests to circumvent Oklahoma Medicaid's prior authorization requirements.
Additionally, it is alleged that CCHS systematically billed federal agencies for presumptive urine drug testing services that were never performed. Wallis is accused of causing these claims to be submitted despite knowing there was no medical purpose for reporting "presumptive results," which were not utilized in treating beneficiaries.
Further allegations state that between November 2018 and January 2023, CCHS billed for unnecessary definitive urine drug testing services. These tests were allegedly ordered under blanket directives or without any order at all and were deemed medically unnecessary.
As a result of these actions, the government asserts it paid millions of dollars on thousands of false claims. The lawsuit seeks recovery of damages with possible trebling and penalties for each false claim submitted by the defendants.
This case is being managed by the U.S. Attorney’s Office for the Western District of Oklahoma alongside Oklahoma's Attorney General’s Medicaid Fraud Control Unit. Various federal investigative bodies provided assistance during the investigation process.
The case is titled U.S. et al. v. Coordinated Care Health Solutions, LLC et al., No. CIV-24-1185-JD (W.D. Okla.). It should be noted that these claims are allegations only with no liability determined yet.