Austin pain specialist Dr. Mark Malone and his practice, Advanced Pain Care, have agreed to shell out $13.6 million to resolve federal and state allegations that the clinic billed Medicare, TRICARE, the Department of Veterans Affairs, and other government programs for unnecessary urine drug tests.
The settlement, announced by federal prosecutors after years of whistleblower suits targeting the practice’s Central Texas locations, is civil only. Officials stressed that civil settlements like this do not amount to criminal findings and that the government has made no determination of liability.
According to a U.S. Attorney's Office announcement, Dr. Malone, Advanced Pain Care, and related entities will pay $13,625,000 in total. Of that amount, the United States will receive $13,590,544.88, and the State of Texas will receive $34,455.12. The settlement resolves five qui tam lawsuits brought under the False Claims Act, and prosecutors again noted that the underlying claims remain allegations, not proven facts.
Austin Pain Management doctor and pain medicine practice to pay $13,625,000 to settle Civil False Claims Act allegations. @OIGatHHS @DoD_IG @USOPM @VetAffairsOIG https://x.com/USAO_WDTX/status/2001778031946506427#m
— USAO_WDTX (@USAO_WDTX) December 18, 2025
How Prosecutors Say the Billing Worked
Federal authorities alleged that Advanced Pain Care routinely billed for both presumptive and definitive urine drug tests for the same patient on the same day, without first looking at the presumptive result to decide whether the more extensive definitive test was actually needed.
Prosecutors also say the practice billed the Department of Veterans Affairs using separate CPT codes for individual drug analytes, specifically the CPT 803XX series, for dates of service between January 3, 2017, and December 31, 2021, as reported by the U.S. Attorney's Office.
Oversight, Integrity Agreement and Compliance Demands
As part of the deal, Advanced Pain Care is now operating under a five-year Corporate Integrity Agreement that layers on extra oversight. The agreement requires the practice to keep a formal compliance program in place, conduct regular risk assessments, and hire an Independent Review Organization to audit its billing and claims activity, according to the HHS Office of Inspector General.
The HHS-OIG listing shows the CIA took effect on November 21, 2025, and is set to run through November 2030. The same listing hosts the signed agreement that spells out the practice’s compliance obligations during that stretch.
Local Footprint and a Texas Pattern
Advanced Pain Care’s own website lists multiple clinics in the Austin area and in other Texas cities, highlighting how many local patients are touched by the entities named in the settlement. The locations page shows several outpatient centers and affiliated pharmacies spread across Central Texas.
Enforcement officials have been here before. An earlier HHS-OIG action shows two Texas pain physicians agreed to pay a combined $3.9 million over allegations that they ordered medically unnecessary urine drug testing, suggesting this new settlement slots into a broader pattern of scrutiny on pain practices. That prior case was documented by HHS-OIG.
What Happens Next
The agreement clears the civil false claims allegations on the table and locks in independent oversight, but it does not rule out more enforcement if auditors or the Independent Review Organization flag new issues down the line.
Assistant U.S. Attorney Thomas Parnham handled the negotiations for the government, and officials say the CIA’s ongoing reviews are meant to ensure that future claims submitted by the practice are medically supported and properly billed.
