Foot fraud? Lexington podiatrist accused of submitting $1 million in false insurance claims

A podiatrist and his company submitted $1 million in false claims to federally funded insurance programs, according to a complaint filed by federal prosecutors in U.S. District Court.

From Jan. 1, 2012, to the present, the Lexington Foot and Ankle Center, at Dr. Michael C. Allen’s direction, “systematically defrauded” Medicare and the Federal Employee Health Benefits Program “by submitting false claims for non-reimbursable routine foot care procedures,” the complaint says.

In addition, the Foot Center, at Allen’s direction, submitted to Medicaid and the Federal Employee Health Benefits Program false claims seeking reimbursement for a level of medical service that Allen and other Foot Center practitioners “did not actually provide,” according to the complaint filed with the courts Wednesday.

Allen is described in the complaint as the owner and operator of the Foot and Ankle Center. Allen’s attorney, Christopher Melton of Louisville, said Lexington Foot and Ankle Center “is committed to operating its practice with the utmost integrity and in compliance with all billing and reimbursement regulations and guidance.”

Since 2010, the Foot Center has had an independent consulting firm conduct regular audits of its medical documentation and billing, Melton said, and it “has consistently been found to be in compliance.”

The Foot Center has been audited by federal and private insurance companies, and its billing and reimbursement “has consistently passed these audits,” Melton said.

That is why the false claims lawsuit filed by the U.S. attorney’s office “is both discouraging and confounding,” Melton said. “The government’s case stems from a lawsuit filed by two disgruntled former employees, which was subsequently dismissed by the United States District Court. The Court found the previous case to be legally deficient and the fact that the United States has chosen to resurrect the case is unfortunate.”

The Foot Center “shall aggressively defend itself against these accusations,” Melton said.

Allen and the Foot Center previously settled a complaint in 2010 for alleged misconduct that included billing Medicare for medically unnecessary nail debridement “when in fact Dr. Allen and the Foot Center were merely trimming toenails,” the complaint says.

Nail debridement involves reducing the nail bulk and girth to the level of normal nail thickness. Trimming involves a reduction in nail length.

“Dr. Allen knows that a nail trim and debridement are not the same thing,” the complaint says.

In the 2010 settlement, Allen and Lexington Foot and Ankle agreed to pay $419,330.98 to settle allegations that they submitted false claims to Medicaid, Medicare and the Office of Personnel Management between January 2002 and February 2007.

The complaint filed Wednesday alleges that similar nail trims — not nail debridements — were performed more recently by the Lexington Foot and Ankle Center.

This story was originally published November 28, 2018 at 6:04 PM.