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Utah Pain Doctor and Medical Practice Settle Medicare Fraud Claims

On July 21st, 2017, Jahan Imani, M.D., and Intermountain Medical Management, P.C., (IMM), a Utah based pain management specialist and his practice, entered into a $399,895.92 settlement agreement with OIG. This resolves allegations that IMM, through Dr. Imani, submitted false or fraudulent claims for payment by inappropriately using modifier 59 for multiple units of HCPCS […]

By |November 5th, 2017|Medical Coding News and Recent Articles|Comments Off on Utah Pain Doctor and Medical Practice Settle Medicare Fraud Claims

Syracuse Area Medical Practice Improperly Billed for Moderate Sedation Services

New York Spine and Wellness Center (under the umbrella of New York Anesthesiology Medical Specialties, P.C.) agreed today to pay $1,941,850.29 to resolve allegations that it improperly billed for moderate sedation services.

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By |November 1st, 2017|Medical Coding News and Recent Articles|Comments Off on Syracuse Area Medical Practice Improperly Billed for Moderate Sedation Services

Under Michigan’s New Medicare RAC Regime, Physician Services Are the Initial Primary Target

An announcement came back in back in October 2016 from the Centers for Medicare & Medicaid Services (CMS). It announced that it had awarded to various entities the next round of contracts to serve as Recovery Audit Contractors (RACs) for their Medicare program. In totality, five separate RAC contractors were awarded. Each one was connected […]

By |September 5th, 2017|Medical Coding News and Recent Articles|Comments Off on Under Michigan’s New Medicare RAC Regime, Physician Services Are the Initial Primary Target

Civil Fraud Case Settlement from Fredericksburg Hospitalist Group amounts to $4.2 Million

Along with 14 of its member shareholders, Fredericksburg Hospitalist Group has agreed to pay nearly $4.2 million to settle a federal False Claims Act case brought under the qui tam whistleblower provisions of the FCA.

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By |September 1st, 2017|Medical Coding News and Recent Articles|Comments Off on Civil Fraud Case Settlement from Fredericksburg Hospitalist Group amounts to $4.2 Million

Medical Practice Agrees To Resolve Allegations Of Overbilling Medicare

St. Agnes Healthcare in Baltimore, Maryland has agreed to pay the United States a sum of $122,928 to resolve issues under the False Claims Act. These allegations allege that they submitted false claims to Medicare by billing for E&M Services at a higher reimbursement rate than the Federal health care programs allowed.

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By |August 28th, 2017|Medical Coding News and Recent Articles|Comments Off on Medical Practice Agrees To Resolve Allegations Of Overbilling Medicare

Due to Improper Billing, Healey Returns $500,000 in Settlement With a Springfield Dentist

Massachusetts Attorney General Maura Healey announced today a settlement with a pediatric dentist in Springfield. Healey’s office returned $500,000 to MassHealth, the state’s Medicaid program, resolving claims that improper billing for services occurred.

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By |August 25th, 2017|Medical Coding News and Recent Articles|Comments Off on Due to Improper Billing, Healey Returns $500,000 in Settlement With a Springfield Dentist

Hospital in Macon will pay $2.5 million to settle billing allegations

The Navicent Health Medical Center has agreed to pay $2.5 million to settle federal allegations that it submitted bills for ambulance trips that were either medically unnecessary or inflated. The settlement follows a 27-month investigation, which was prompted by a whistleblower.

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By |August 7th, 2017|Medical Coding News and Recent Articles|Comments Off on Hospital in Macon will pay $2.5 million to settle billing allegations

Carolina Healthcare System Agrees To Pay $6.5 Million

The Charlotte-Mecklenburg Hospital Authority, dba Carolinas Healthcare System (CHS), has agreed pay the Government $6.5 million according to U.S. Attorney Jill Westmoreland Rose. This was to resolve allegations that the company violated the False Claims Act, by “up-coding” claims for urine drug tests in order to receive higher payment than allowed for the tests. The settlement […]

By |July 6th, 2017|Medical Coding News and Recent Articles|Comments Off on Carolina Healthcare System Agrees To Pay $6.5 Million

Norman Orthopedic Practice Pays $1,537,796

Orthopedic and Sports Medicine Center-Norman (collectively “OSC”) have paid $1,537,796 to settle civil claims stemming from allegations that they submitted false claims to Medicare, Medicaid, the Department of Veterans Affairs, and TRICARE. In reaching this settlement, OSC did not admit liability, and the government did not make any concessions regarding the legitimacy of the claims. The agreement […]

By |June 28th, 2017|Medical Coding News and Recent Articles|Comments Off on Norman Orthopedic Practice Pays $1,537,796

Richmond Hospitalist Group Settles Federal FCA Case

Fredericksburg Hospitalist Group, located in Richmond, VA, and fourteen of its member shareholders have agreed to pay nearly $4.2 million to settle a federal FCA case brought under the “qui tam whistleblower” provisions. Dana J. Boente, U.S. Attorney for the Eastern District of Virgini, said, “Rooting out fraudulent billing by healthcare providers is a priority. This […]

By |June 19th, 2017|Medical Coding News and Recent Articles|Comments Off on Richmond Hospitalist Group Settles Federal FCA Case