Coding Compliance Risk

$1.85 Million Paid to Settle Urology Modifier 25 Whistleblower Case

By |2020-04-13T18:08:11+00:00July 19th, 2019|

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 [...]

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

By |2020-04-13T18:08:30+00:00June 21st, 2019|

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 [...]

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

By |2020-04-13T18:08:51+00:00June 19th, 2019|

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 [...]

Florida Physicians and Practice Settle False and Fraudulent Claims Case

By |2020-04-13T18:26:42+00:00June 18th, 2019|

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 [...]

Connecticut Diagnostic Services Provider Settles Case Involving False Claims

By |2020-04-13T18:26:56+00:00June 14th, 2019|

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 [...]