Provider Fraud
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August 16, 2019
Kentucky-based Ultimate Care Medical Services, LLC, doing business as Ultimate Treatment Center, and its principal, Dr. Rose O. Uradu, have agreed to pay $1.4 million to resolve allegations that they submitted false claims to Mediare and Kentucky's Medicaid program for services that were not provided. Defendants billed for "evaluation & management" services when patients visited the clinic to receive methadone, visits which did not include a medical examination, which is required to bill for evaluation & management. In addition, defendants billed for complex urine drug testing when they lacked the equipment to perform such testing, and issued buprenorphine prescriptions at an rate greater than authorized. USAO ED KYAugust 15, 2019
Alabama-based Baldwin Bone & Joint, P.C. (BB&J) has settled a False Claims Act action for $1.2 million. According to the whistleblower who initiated the action, former BB&J employee John Seddon, BB&J submitted claims to Medicare and TRICARE for physical therapy services performed by unauthorized providers, and compensated shareholder physicians based on the volume of physicians’ internal referrals. As part of the settlement, Seddon will receive a $200,000 relator’s share. USAO SDALJuly 18, 2019
Connecticut-based Comprehensive Pain and Headache Treatment Centers, LLC (CPHTC), and owner Mark Thimineur, M.D., have settled federal and state False Claims allegations of improperly submitting claims for urine tests that were not performed or were already part of drug screens paid for by Medicare and Medicaid. As part of the settlement, they will pay $425,000. USAO CTQuestion of the Week — Is DOJ’s Blockbuster $1.4 Billion Opioid Settlement Just the Tip of the Iceberg?
Posted 07/12/19
