About Christian Roule

Christian works as the Site Administrator and Content Copywriter for The Coding Network. He is a published author and a member of the IT Team.

Doctor Sentenced to Prison for Health Care Fraud

By |2019-08-01T21:39:09+00:00July 23rd, 2019|Medical Coding News and Recent Articles|

In court in Central Islip, Hal Abrahamson, a foot doctor with offices in Plainview, Long Island, and Rego Park, Queens, was sentenced by US District judge Denis R. Hurley to at least one year and a day in jail for his role during a health care fraud scheme. The Court additionally ordered Abrahamson to pay [...]

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$1.85 Million Paid to Settle Urology Modifier 25 Whistleblower Case

By |2019-08-01T21:34:26+00:00July 19th, 2019|Medical Coding News and Recent Articles|

Separately asking routine evaluation and management (E/M) services provided on a similar day as another procedure is usually denied by Medicare. Care providers might typically individually bill E/M services if they meet certain criteria and append modifier 25 vital, on an individual basis specifiable analysis and management service by a similar MD or different qualified [...]

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Michigan doctor accused of $60M Fraud

By |2019-08-01T21:27:08+00:00July 16th, 2019|Medical Coding News and Recent Articles|

An indictment unsealed July ten charges Vasso Godiali, MD, with orchestrating a $60 million care fraud scheme and lavation payoff from the scheme, per the Department of Justice. Dr. Godiali, a vascular physician, allegedly submitted false claims to Medicaid, Medicare and Blue Cross of Michigan for services that weren't provided and exploited Modifier fifty nine [...]

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DOJ Pursues a Number Of EHR Cases: Five Things For You to Understand

By |2019-06-18T22:10:55+00:00June 21st, 2019|Medical Coding News and Recent Articles|

The United States DOJ is initiating direct legal proceedings against Hospitals, Health Care systems, and Medical Technology Corporations for submitting an exhaustive number of false claims to both Medicare and Medicaid. This action is in concordance with the Electronic Health Records (EHR) incentive program, per the National Law Review. Click Here to Read the Full [...]

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Los Angeles Doctor Condemned In 33 Million Dollar Fraud Scheme

By |2019-06-18T22:05:06+00:00June 20th, 2019|Medical Coding News and Recent Articles|

A United States Federal Jury found Dr. Robert Glazer guilty on June 7th for his primary role during a 33 million dollar fraud scheme concerning requests of Medicare for care services that were not actually provided. Following a seven-day trial, Dr. Glazer was found guilty of a single count of Conspiracy to Commit Fraud and [...]

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Kansas Doctor Forks Over Almost 6 Million in Settling 3rd False Claims Case in Twenty Years

By |2019-06-18T21:55:27+00:00June 19th, 2019|Medical Coding News and Recent Articles|

Joseph P. Galichia MD, the previous owner of the Wichita-based Galichia Medical, after quite some time, reached Fraud Claim Act settlements with the Feds in 2000 and 2009 amounting to nearly 6 Million Dollars. This was his third time settling with the US Federal Government for such behavior. Click Here to Read the Full Story!

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Westside Los Angeles Dentist Being Sent To Prison

By |2019-06-18T21:42:54+00:00June 18th, 2019|Medical Coding News and Recent Articles|

A West Los Angeles dental practitioner was sentenced last week to forty months in federal jail for a health-care insurance fraud scheme during which he submitted phony billings for crowns and fillings that were not ever really provided to patients. Benjamin Rosenberg, 59, pleaded guilty in January to one federal count of health care fraud, [...]

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Florida Physicians and Practice Settle False and Fraudulent Claims Case

By |2019-06-18T03:12:03+00:00June 18th, 2019|Medical Coding News and Recent Articles|

Jaime L. Sepulveda, MD, LLC (d/b/a Miami Urogynecology Center), Jaime L. Sepulveda, M.D., and Sujata Yavagal, M.D. (collectively, "Miami Urogynecology Center"), South Miami, Florida, entered into a $173,768.08 settlement agreement with OIG. The settlement agreement resolves allegations that Miami Urogynecology Center submitted claims to Medicare for items or services that it knew or should have [...]

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Connecticut Diagnostic Services Provider Settles Case Involving False Claims

By |2019-06-13T22:42:17+00:00June 14th, 2019|Medical Coding News and Recent Articles|

On November 19, 2018, Southern Connecticut Vascular Center, LLC (SCVC), Stratford, Connecticut, entered into a $792,076.76 settlement agreement with OIG. The settlement agreement resolves allegations that SCVC submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 96965 when those claims were for a procedure that was already included as a component of the duplex ultrasound [...]

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California Physician and Practice Settle Case Involving False Claims

By |2019-06-13T22:41:22+00:00June 14th, 2019|Medical Coding News and Recent Articles|

On December 20, 2018, Michael Jadali, D.O., and the Center for Pain & Rehabilitation Medicine (collectively, "Dr. Jadali"), San Jose, California, entered into a $60,406.30 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. Jadali submitted claims to Medicare for Healthcare Common Procedure Coding System codes 80500 (clinical pathology consultation; limited, without review of [...]

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