A Clarksville medical practice has agreed to pay $2.8 million to resolve federal allegations that it improperly billed Medicare and TRICARE for services performed by non-physician practitioners using doctors' National Provider Identifier numbers. The allegations against Premier Medical Group, located at 490 Dunlop Lane, cover claims submitted from November 1, 2018, through May 31, 2023.
The settlement was announced by United States Attorney Braden H. Boucek, according to Main Street Media of Tennessee. Premier Medical Group, P.C. is described as a multi-physician practice, and the allegations center on claims submitted to Medicare and TRICARE for services by non-physician practitioners that were billed using physicians' NPI numbers rather than the providers who actually performed the work, per clarksvillenow.com. As with any settlement, the claims remain allegations only and have not resulted in a determination of liability.
Premier Says It Flagged the Problem Itself
Premier Medical Group has pushed back on the fraud characterization, framing the matter as an internal discovery rather than a scheme. This matter is related solely to a coding issue, the company said, according to the same clarksvillenow.com report, adding that it self-reported and resolved the issue several years ago.
The practice also said no patient or payer was billed for a service that was not provided, and maintained the matter raised no concerns about the quality of care delivered to patients. Premier further stated it has not agreed that any wrongdoing occurred and was not required to enter a corporate integrity agreement or action plan as part of the resolution, the outlet reported.
Federal Officials Frame the Case Around Program Integrity
Boucek said federal health care programs depend on providers following the rules and billing taxpayers accurately, and that improper claims undermine programs relied on by millions of Americans, service members and veterans for essential care. He said his office will continue working with law enforcement partners to protect federal health care programs and taxpayer funds.
Nakia M. Alexander said holding fraudulent providers accountable is essential to safeguarding TRICARE, the military's primary health care program, and said the settlement reinforces efforts to preserve health care resources for service members, retirees and their families while signaling that fraudsters will be investigated. The matter was investigated by the United States Attorney's Office for the Middle District of Tennessee with assistance from the Defense Criminal Investigative Service, and the United States was represented by Assistant United States Attorney Wynn M. Shuford.
A Pattern Seen Beyond Clarksville
Premier Medical Group describes itself as having been established in 1995, according to the practice's own website. Cases alleging improper Medicare and TRICARE billing have surfaced at other practices around the country. In 2017, Family Medicine Centers of South Carolina agreed to pay $1.56 million, with two company officials paying a combined $443,000, to resolve allegations of false Medicare and TRICARE claims, according to Military Times.
That South Carolina case involved different allegations than those against Premier, including claims for medically unnecessary laboratory services and a physician incentive plan that paid doctors a percentage of the value of diagnostic tests they ordered through the company, Military Times reported. The company in that case said it admitted no liability and adamantly denied any wrongdoing. Nationally, the Justice Department has reported that False Claims Act settlements and judgments exceeded $6.8 billion in the fiscal year ending September 30, 2025, according to the U.S. Department of Justice.
