Office Manager and Wife of Conway Arkansas Doctor Arrested for Medicaid Fraud

Leslie Rutledge, an Attorney General for the State of Arkansas, announced today that a Conway Optometrist's Officer Manager had been arrested and charged with for defrauding almost $600K from the Arkansas Medicaid Program during the course of a four-year period. Attorney General Rutledge went on record saying that “Medicaid funds are crucial to assist some [...]

By |2019-11-27T14:44:50+00:00November 27th, 2019|Medical Coding News and Recent Articles|Comments Off on Office Manager and Wife of Conway Arkansas Doctor Arrested for Medicaid Fraud

Lenox Hill Hospital Pays $12.3 Million Settlement For Submitting Fraudulent Medicare Claims

The US Attorney for Manhattan, New York, and a Special Agent for the OIG's New York Regional Office, announced today that the US Federal Government has settled a civil fraud suit against Lenox Hill (a Manhattan Hospital) and its corporate parent Northwell. The Government’s complaint alleges that the two Defendants violated the False Claims Act [...]

By |2019-11-25T03:58:09+00:00November 25th, 2019|Medical Coding News and Recent Articles|Comments Off on Lenox Hill Hospital Pays $12.3 Million Settlement For Submitting Fraudulent Medicare Claims

Company Owner Goes to Jail for Medicaid Fraud

The owner of a transport company has pleaded guilty to fraudulently charging the good citizens of Massachusetts millions in false claims through the state’s Health Care Program known as MassHealth. The 59 year old Michael Davini plead guilty in court at Worchester on October 24th to charges of felony larceny to amounts exceeding $250, committing [...]

By |2019-11-06T19:04:25+00:00November 6th, 2019|Medical Coding News and Recent Articles|Comments Off on Company Owner Goes to Jail for Medicaid Fraud

Anesthesia Place in Traverse City Will Now Pay $600K For Falsifying Claims to Medicare

According to the United States DOJ, Traverse Anesthesia Associates, along with several anesthesiologists are paying over $600K to resolve allegations that they consciously incorrectly submitted certain anesthesia claims to Medicare. Investigators mentioned that TAA and six of their anesthesiologists didn't meet the regulative needs and conditions of payment for billing those services as medically directed. [...]

By |2019-10-15T19:19:37+00:00October 15th, 2019|Medical Coding News and Recent Articles|Comments Off on Anesthesia Place in Traverse City Will Now Pay $600K For Falsifying Claims to Medicare

Virginia Beach Psychiatrist Grossly Over-booked Patients as Part of Fraud

A psychiatrist double, triple and even quadruple overbooked patients at his Virginia Beach practices so as to over bill insurance firms by over $460,000, per court documents. Udaya Shetty, of behavioral & medicine group and a lot of recently Quietly Radiant Psychiatric Services, pleaded guilty Wednesday to at least one count of health care fraud. [...]

By |2019-09-26T20:22:26+00:00September 26th, 2019|Medical Coding News and Recent Articles|Comments Off on Virginia Beach Psychiatrist Grossly Over-booked Patients as Part of Fraud

Doctor’s Practice to Pay Nearly $180K to Resolve False Claims Act Liability Regarding “P-Stim” Devices

First Assistant U.S. Lawyer Jennifer Arbittier Williams proclaimed that Richard P. Frey, D.O., and Physicians Alliance Ltd. (“PAL”) have agreed to pay nearly $180,000 to resolve liability underneath the False Claims Act for the alleged improper charge of “P-Stim” devices. From may 2013 through June 2014, Frey and PAL billed Medicare for the implantation of [...]

By |2019-09-24T22:11:58+00:00September 24th, 2019|Medical Coding News and Recent Articles|Comments Off on Doctor’s Practice to Pay Nearly $180K to Resolve False Claims Act Liability Regarding “P-Stim” Devices

Announcements from the OIG (September 2019)

Alabama Ambulance Provider Settles Case Involving False Claims On June 28, 2019, Samaritan EMS, Inc. (Samaritan), Union Grove, Alabama, entered into a $942,373.67 settlement agreement with OIG. The settlement agreement resolves allegations that Samaritan submitted basic and advanced life support ambulance claims where the trips were to destinations for which ambulance services are not covered by [...]

By |2019-09-24T22:13:02+00:00September 20th, 2019|Medical Coding News and Recent Articles|Comments Off on Announcements from the OIG (September 2019)

The OIG calls out a CA Medical Group for Inaccurate Charges

Santa Monica, California based Oceanside MedicalGroup did not comply with Medicare necessities when charging for psychotherapy services, in keeping with a report from Health and Human Service's OIG. The Office of Inspector General said none of the hundred sampled beneficiary days, comprising of 103 psychotherapy services, complied with Medicare any needs. Furthermore, within the majority of cases, [...]

By |2019-09-12T22:11:57+00:00September 12th, 2019|Medical Coding News and Recent Articles|Comments Off on The OIG calls out a CA Medical Group for Inaccurate Charges

RUC & CMS: The Difference Between Them Could Mean Money To Doctors

Physicians ought to review the direct monetary impact as several of the managed care contracts can pay these auxiliary services at the CMS RVU rates. the great news is they aren't set in stone; so doctors can discuss the projected WRVUs or the other a part of the rule until September 27th. Read The Full [...]

By |2019-08-22T19:13:24+00:00August 22nd, 2019|Medical Coding News and Recent Articles|Comments Off on RUC & CMS: The Difference Between Them Could Mean Money To Doctors

Gate City Transportation Sentenced For Health Care Fraud For Over $5 Million

A Greensboro-based medical transport company was sentenced in court for health care fraud after pleading guilty to one count of health care fraud in October 2018, according to US Attorney lawyer Matthew G.T. Martin of the District of North Carolina. The company in question, Gate City Transportation, was ordered to pay a $100 fine, a [...]

By |2019-08-19T20:18:38+00:00August 19th, 2019|Medical Coding News and Recent Articles, Uncategorized|Comments Off on Gate City Transportation Sentenced For Health Care Fraud For Over $5 Million