Antigravity Effects and Results Laboratories: Knee Braces and Clinic Kickbacks

In the Antigravity Effects Results Laboratories settlement, the companies, their owner and an employee agreed to pay $500,000 over allegations of unnecessary knee injections and braces, with kickbacks tied to brace purchases. The Justice Department described a business that licensed the clinics’ treatment model, arranged supplies and collected fees tied to clinic collections. For someone inside clinic operations, purchasing or billing, the case reaches well beyond the person who submitted the Medicare claim.

The Justice Department announced the settlement on November 20, 2020. It alleged that the defendants caused clinics to submit false Medicare claims from 2011 through 2017.

How the Clinic Network Worked

According to the Justice Department, Antigravity Effects licensed branding and business methods to chiropractors across the country. Those arrangements led to the Osteo Relief Institutes, including a clinic in Minnesota. Antigravity and its owner received license fees based on the clinics’ collections.

Results Laboratories handled another part of the business. The Justice Department described it as a group purchaser through which the clinics ordered medical supplies, including viscosupplements and custom knee braces. The same person owned both companies, and the employee who joined the settlement worked for Antigravity.

The license fee connected Antigravity’s income to what the clinics collected. The purchasing arrangement put Results between the clinics and their suppliers.

That structure explains why this durable medical equipment fraud case reached beyond individual clinics. The government alleged that the people directing the business and arranging purchases caused the clinics to send Medicare the false bills.

Knee Injections Without Clinical Support

The government alleged that Antigravity, Results, their owner and the employee pressured clinics to give knee injections to patients who did not need them. It also alleged successive use of different injection brands without clinical support and use of discounted viscosupplements reimported from foreign countries. The issue was why the next injection happened at all.

Viscosupplementation treats osteoarthritis by injecting a gel-like fluid into the knee joint to lubricate it and supplement the joint’s natural fluid. Antigravity licensed a business model built around that treatment. The government’s allegation was that commercial pressure reached the decision about which patients received it and how it was repeated.

Knee Brace Purchases That Paid the Intermediary

Results and its owner allegedly solicited and received kickbacks from Vision Quest, a knee brace manufacturer in Irvine, California, in exchange for arranging clinic purchases. The settlement covered allegations that the clinics supplied unnecessary custom knee braces and that those braces were also tainted by the payments.

The government’s complaint against Vision Quest describes the arrangement in more detail. It alleged that Vision Quest paid Results commissions of 20% to 35% on every brace a participating clinic purchased. The intermediary arranging a clinic’s purchase was, the government alleged, also getting paid by the seller for that purchase.

According to the complaint, the owner and employee required communications between the manufacturer and clinics to pass through them, preventing direct contact that could expose the commissions. It also alleged that clinics paid higher prices than competitors charged, and that former participating clinics received better prices from Vision Quest after ending their Antigravity arrangements.

The alleged commercial pressure reached clinic staff. The complaint described an instruction to a Colorado chiropractor to review the following week’s patient files and plan to give all of those patients braces. It also quoted an intermediary’s frustration with patients leaving without one:

The government alleged that clinic staff were pushed to turn patient visits into brace orders while the business arranging the purchases received a commission on each one. Patients got braces they did not need, and Medicare and taxpayers got the bill, according to that account.

Custom Braces and the Wrong Patient Photographs

The complaint alleged that the communication restriction kept Vision Quest from giving clinics instructions or correcting poor-quality photographs used to manufacture custom braces. It alleged that the manufacturer accepted that damage to brace quality to keep the clinics’ business.

One example concerned a Minnesota clinic’s order for braces for both knees. According to the complaint, a Vision Quest order-processing specialist recognized that the knee photographs were obviously from different patients and asked the Antigravity employee to have the clinic fix them. The complaint says the employee responded that the clinic had reviewed the pictures and said they looked good.

A custom brace depends on information about the person who will wear it. Here, the government alleged that the restriction protecting the commission arrangement also obstructed the exchange of information needed to make the product. The purchasing relationship and the quality of the brace met in the same order file.

How Medicare Claims Data Led to the Investigation

The Antigravity and Results allegations grew out of a proactive government investigation based on Medicare claims-data analysis. The Justice Department said that work also led to previously announced settlements with former Osteo Relief Institutes and others.

The complaint’s details show what an insider can add to the billing pattern: who pushed clinic staff to order braces, how the purchaser was paid and why a manufacturer could not speak directly to the clinics using its products. A commission agreement or an exchange about patient photographs can explain a business decision behind a claim.

The Settlement’s Contingent Payment and Individual Terms

The Antigravity and Results settlement was based on the companies’ and individuals’ ability to pay. The Justice Department said the amount could reach $3.875 million if certain contingencies were triggered.

The owner also agreed to an eight-year exclusion from federal health care programs, and the employee agreed to a five-year exclusion. Both companies had stopped operating by the announcement.

The Clinics and Manufacturer Had Separate Settlements

Seven former Osteo Relief Institutes and their owners had already agreed to pay more than $7.1 million in a settlement announced on October 18, 2019 that also resolved a whistleblower’s qui tam case.

Vision Quest Industries later agreed to pay $2,250,000 in a settlement announced on August 30, 2022.

Together, these cases follow the same business from the clinics submitting claims to the intermediary arranging purchases and the manufacturer supplying the braces. In the government’s account, the clinic bill was the end of a series of commercial decisions. The government pursued the businesses behind those decisions as well as the clinics.

What Evidence Is Needed to Report Medicare Fraud?

We look for evidence connecting the pressure to treat patients or the payments behind an order to the claims sent to Medicare. Clinical records, orders and payment arrangements can show that connection. The Antigravity and Vision Quest allegations make that connection concrete: collection-based license fees, commissions on brace purchases, pressure to order and patient photographs that the manufacturer questioned.

A clinic employee may know what happened when a patient arrived. A purchasing or manufacturer employee may know why an order went through, what payment it generated or why direct communication was blocked. Our whistleblower experts work with you to connect that knowledge to the claims and the people making the decisions.

What Is the Reward for a Medicare Fraud Whistleblower?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Know How the Orders Happened

If you saw brace orders driven by commissions or clinic pressure to treat patients who did not need it, speak to our whistleblower experts about how those orders happened. We work with you to build your strongest healthcare fraud whistleblower case, bring in healthcare fraud whistleblower lawyers who understand clinic billing and equipment kickbacks, and stay alongside you through the pursuit of a recovery.