SAN DIEGO (FOX 5/KUSI) — A local physician and her former practice, The Center for Health & Wellbeing in San Diego, has reached a settlement of $3.8 million in response to allegations of submitting false claims to Medicare and TRICARE. This settlement, announced by the U.S. Attorney’s Office, resolves claims that spanned a decade, from 2012 to 2022.
The allegations centered around Dr. Janette J. Gray’s clinic, which marketed itself as an “alternative,” “integrative,” and “holistic” medical facility. The practice employed a range of medical professionals, including doctors, nurse practitioners and mental health experts. It specialized in treatments such as IV infusion therapy and hormone/supplement therapy.
Investigators accused Dr. Gray and her practice of engaging in several fraudulent billing practices. These included misrepresenting the services provided, disguising the rendering provider, “unbundling” services (billing for a single procedure as multiple separate services) and billing for medically unnecessary treatments.
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In addition to the financial settlement, Dr. Gray will be barred from participating in Medicare, Medicaid and all federal health care programs for the next five years.
U.S. Attorney Tara McGrath emphasized the importance of integrity in healthcare, stating, “When a doctor engages in billing fraud, we will protect patients and taxpayers from deceit.”
The case also drew attention from the Department of Defense’s Office of Inspector General. Special Agent in Charge Bryan D. Denny noted the significant financial implications of the alleged fraud, stating, “This civil settlement holds Dr. Gray and her former medical practice accountable for questionable actions that circumvented TRICARE billing guidelines, costing American taxpayers millions of dollars.”
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FBI San Diego Acting Special Agent in Charge Houtan Moshrefi reiterated the commitment to combating healthcare fraud, emphasizing the collaborative efforts of law enforcement in addressing violations of the healthcare system.
The settlement was achieved through a coordinated effort involving multiple agencies, including the U.S. Attorney’s Office for the Southern District of California, the Department of Health and Human Services, DCIS, and the FBI. Assistant U.S. Attorney Maritsa A. Flaherty led the case.
While the claims resolved by the settlement remain allegations only and no liability has been determined, the case underscores the government’s ongoing efforts to tackle healthcare fraud. Individuals can report potential fraud or abuse to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
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