San Diego Doctor to Pay $3.8M and Barred from Federal Health Programs For Fraud

Dr. Janette J. Gray and her practice will pay $3.8 million to settle allegations of Medicare and TRICARE fraud.Photo byHush Naidoo Jade PhotographyonUnsplash

Dr. Janette J. Gray of San Diego and her former medical practice, The Center for Health & Wellbeing, have agreed to pay $3.8 million to resolve allegations of violating the False Claims Act by knowingly submitting false claims to Medicare and TRICARE, according to the U.S. Attorney's Office for the Southern District of California.

The settlement resolves allegations that from 2012 to 2022, Dr. Janette J. Gray and her practice billed Medicare and TRICARE for non-covered services by disguising the provider, misrepresenting services, "unbundling" procedures (billing for parts of a service separately instead of using a single code), or billing for services not medically necessary, according to the U.S. Attorney's Office.

In addition to the $3.8 million settlement, Dr. Gray will be excluded from participating in Medicare, Medicaid, and all other federal health care programs for five years, the department says.

“The civil settlement holds Dr. Gray and her former medical practice accountable for questionable actions that circumvented the TRICARE billing guidelines and allowed them to receive payments for services that should not have been reimbursed by TRICARE, costing American taxpayers millions of dollars,” said Bryan D. Denny, Special Agent in Charge of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service, Western Field Office.

“DCIS and its partners will always aggressively investigate those who defraud TRICARE, because those deceptive actions ultimately harm those defending our country and their families.”

Notably, the claims resolved by the settlement are allegations only, and there has been no determination of liability.