BTW Settles Whistleblower Suit on Overbilling of Federal Workers’ Comp Program

BTW Solutions bills itself as a drug wholesaler and billing service – and as a way for physicians to maximize profits on workers’ compensation and personal-injury-protection patients through the use of topical creams and durable medical equipment.

The Benton, Arkansas-based company even produced a brochure that said doctors could add more than $100,000 in annual revenue if just five patients per week were prescribed certain pain creams.

Federal prosecutors said it was all part of an illegal scheme that sold physicians drugs at cost then billed the federal Office of Workers’ Compensation Programs (OWCP) at as much as 12 times that cost. BTW would often split the profits with the doctors, according to court records and federal officials.

This week, BTW Solutions agreed to pay $1.5 million to settle a civil suit that started more than seven years ago with a whistleblower who worked for BTW.

“This settlement allows the OWCP to recover medical bill payments under the Federal Employees’ Compensation Act and return these funds to the Employees’ Compensation Fund,” said OWCP Director Christopher Godfrey.

It all began in 2015, when Elizabeth Young, now a Florida resident, worked for BTW as an outside sales agent, selling products and services to doctors in Georgia, according to complaints filed in the case. Young knew the business, court documents indicate: She had more than 25 years of experience in the field, managing sales of drugs, creams and medical equipment to doctors’ offices.

After leaving BTW, Young filed a qui tam suit in 2017, alleging that BTW, along with a compounding company and 10 physicians had for years violated anti-kickback statutes and the federal False Claims Act, cheating the federal workers’ comp program of significant funds.

In 2023, the U.S. government intervened in the suit.

After initial concerns were raised by some Georgia doctors, BTW reportedly said not to worry, according to court documents. The firm’s general counsel told them that “BTW Does not bill Medicare or Medicaid, and thus does not fall under the STARK Act… For this same reason, The Federal Anti-Kickback statutes (AKS) do not apply to the Business Model of BTW…”

“This advice was and is wrong,” prosecutors wrote in the federal complaint. “The AKS applies to all federal health care programs, including OWCP, and BTW knew as much.”

After months of court filings and negotiations, BTW agreed to settle.

“The Anti-Kickback Statute protects medical decision-making from being corrupted by improper financial considerations,” said Peter Leary, the U.S. Attorney for the Middle District of Georgia. “I am proud of our office’s efforts litigating this unique and difficult case involving an often-overlooked program designed to provide needed healthcare to injured federal workers.”

The settlement does not include an admission of guilt by BTW, the U.S. Attorney said.

It’s unclear what fate awaits the accused physicians and the compounding company named in the suit. It also was not included in the prosecutor’s news release or court records about the share of the settlement that will go to Young, the whistleblower. Most qui tam actions allow the plaintiff to recover 15% to 25% of the award or settlement, according to news reports.

Young’s attorneys could not be reached for comment over the holiday period. BTW representatives also could not be reached, but the firm’s answer to the federal complaint can be seen here.