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Respironics to pay over $ 24 million in kickbacks scheme. Maryland, other states, and the federal government have reached a settlement with Philips RS North America LLC on behalf of Respironics, a subsidiary to resolve alleged false claims. The durable medical equipment (DME) manufacturer of devices such as ventilators, oxygen concentrators, CPAP and BiPAP machines, and […]
The post DME Manufacturer Settles in Alleged False Claims Act Violation appeared first on AAPC Knowledge Center.
The blood test distributor agrees to pay $ 195,000 to settle allegations that it violated the FCA. The U.S. Department of Health and Human Services Office of Inspector General (OIG) lately conducted an investigation into False Claims Act (FCA) violations by GlycoMark, Inc. The OIG alleges that GlycoMark encouraged providers to submit claims for its hyperglycemia […]
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Billing consultant implicated in healthcare provider’s wrongdoing. Can I be prosecuted for fraud because of my involvement in submitting a false claim? This is a common question from coding and billing personnel, especially when they have concerns regarding the codes and modifiers they are directed to bill relative to provided healthcare services and supplies. While […]
The post FCA Settlement Clarifies False Claims Liability for Consultants appeared first on AAPC Knowledge Center.
Illinois Physician Settles Case Involving False Claims
The settlement agreement resolves allegations that Dr. Tolitano submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 93965, when those claims were for a procedure that was already included as a component of the duplex ultrasound procedures for which Dr. Tolitano submitted claims using HCPCS codes 93970 or 93971 for the same beneficiary on the same dates of service.
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Texas Physician and Practice Settle Case Involving False Claims
The settlement agreement resolves allegations that Dr. Robbins submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 93965, when those claims were for a procedure that was already included as a component of the duplex ultrasound procedures for which Dr. Robbins submitted claims using HCPCS codes 93970 or 93971 for the same beneficiary on the same dates of service.
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New Mexico Physician and Practice Settle Case Involving False Claims
The settlement agreement resolves allegations that Dr. Reddy submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 93965, when those claims were for a procedure that was already included as a component of the duplex ultrasound procedures for which Dr. Reddy submitted claims using HCPCS codes 93970 or 93971 for the same beneficiary on the same dates of service.
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A Texas physician was found guilty Jan. 15 for his role in a $ 325 million healthcare fraud scheme that involved falsely diagnosing patients with various degenerative diseases and then administering chemotherapy and other toxic drugs to patients based on the false diagnoses, according to the Department of Justice.
After a 25-day trial, Jorge Zamora-Quezada, MD, was convicted of one count of conspiracy to commit healthcare fraud, seven counts of healthcare fraud and one count of conspiracy to obstruct justice.
Dr. Zamora-Quezada was charged in an indictment unsealed in May 2018. In addition to falsely diagnosing patients and administering unneeded drugs, he also allegedly conducted a battery of other fraudulent and excessive medical procedures on patients to increase revenue and fund his opulent lifestyle. Many patients, some as young as 13, suffered physical and emotional harm as a result of the false diagnoses and unnecessary procedures and chemotherapy injections, according to the Justice Department.
Read the full story on Becker’s Hospital Review here.
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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 neurostimulator electrodes, a surgical operation generally necessitating an OR for which Medicare reimburses thousands of dollars. Frey didn’t conduct surgery, however. Instead, he applied a “P-Stim” device in a workplace setting while not using surgery methods or general anaesthesia.
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The post Doctor’s Practice to Pay Nearly $ 180K to Resolve False Claims Act Liability Regarding “P-Stim” Devices appeared first on The Coding Network.
Beaver Medical Group L.P. (BMG) and a doctor who works for it, Dr. Sherif Khalil, have agreed to pay a little over the amount of $ 5 million to resolve accusations that they falsely reported diagnosis codes to plans of Medicare Advantage, thereby causing said plans to receive inflated payments. BMG is headquartered in Redlands, CA. “The United States relies on healthcare providers to submit accurate diagnosis data to Medicare Advantage plans to ensure those plans receive the appropriate compensation,” said Jody Hunt, Assistant Attorney General of the DOJ’s Civil Division. “We will pursue those who undermine the integrity of the Medicare program and the data it relies upon.”
The post Medicare Advantage Supplier and Doctor to Pay $ 5 Million to Settle False Claims Act Allegations appeared first on The Coding Network.
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.
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