February 13, 2026
The U.S. Department of Justice has reached a $13.6 million healthcare billing fraud settlement with an Austin-based pain management medical practice in a case that began with a Waters Kraus Paul & Siegel whistleblower client.
According to the settlement announced December 18, Dr. Mark Malone, Advanced Pain Care and related parties will pay $13,625,000 to resolve allegations that they fraudulently billed federal and state healthcare programs, including Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program.
Qui Tam Whistleblower Exposes Billing Fraud Scheme
According to court records, the defendants had a practice of billing the healthcare programs for both presumptive and definitive urine drug testing on the same date of
service without first reviewing the results of the presumptive tests to determine
whether the definitive tests were medically necessary. The medical group operated in and around Austin, Amarillo, Waco and Houston.
The case began when a Waters Kraus Paul & Siegel client came forward with details about the scheme and filed a qui tam whistleblower action under the federal False Claims Act. The U.S. Justice Department later joined the case and took over the investigation and ultimately secured the settlement.
A Powerful Tool to Expose Fraud
The False Claims Act is the government’s primary tool for combatting fraud billing to government programs. By law, whistleblowers are entitled to 15 to 25 percent of the recovered damages.
“Cases like this one are only possible because whistleblowers have the courage to speak up,” said Waters Kraus Paul & Siegel attorney Kay Gunderson Reeves. “The False Claims Act empowers people to expose fraud that drains public resources and drives up healthcare costs, while holding wrongdoers accountable for abusing government programs.”
The Department of Health and Human Services Office of Inspector General, DoD Office of Inspector General Defense Criminal Investigative Service, Office of Personnel Management Office of Inspector General, and Department of Veterans Affairs Office of Inspector General participated in the investigation of this matter. Assistant U.S. Attorney Thomas Parnham negotiated the settlement on behalf of the government.
About Waters Kraus Paul & Siegel
Waters Kraus Paul & Siegel is a national plaintiffs’ law firm devoted to helping families in personal injury and wrongful death cases involving asbestos and mesothelioma, benzene exposure, dangerous pharmaceuticals, medical devices, and birth defects caused by pesticides, toxic chemicals, opioid use, and semiconductor chip manufacturing. The law firm also represents plaintiffs in qui tam whistleblower matters and cases that uncover false claims submitted to the government. Based in Dallas, Texas, with offices in Los Angeles, California, and Moline, Illinois, Waters Kraus Paul & Siegel has represented families from all fifty states and many foreign countries, as well as foreign governments.
Our Results
Historic settlement for over 1,300 survivors of clergy and adult abuse within the Roman Catholic Archdiocese of Los Angeles, marking a pivotal moment for justice.
A Philadelphia jury awarded a record verdict against ExxonMobil for failing to warn about cancer risks due to benzene in its petroleum products.
Private equity firm and co-defendants agree to pay $25M in Medicaid fraud case alleging mental health services provided by unqualified providers.
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