Whistleblower News From The Inside -- June 8, 2017

By the C|C Whistleblower Lawyer Team

Virginia hospitalist group settles FCA suit for $4.2M—Fredericksburg Hospitalist Group has settled allegations that it and its member doctors intentionally upcoded evaluation and management (E&M) codes to the highest level allowable under Medicare billing rules, resulting in fraudulently increased reimbursements. E&M codes are a subset of medical procedure code that categorize the amount of time and effort a medical professional exerts during a visit with a patient, there are five levels which are reimbursed at different rates. The case was brought by a whistleblower. USAO Eastern District of Virginia

Texas physical therapy clinic settles FCA suit for $3M—Union Treatment Center has settled allegations that it perpetrated a scheme to defraud the Federal Workers’ Compensation Program. According to the government’s allegations, Union billed the program for services that were never rendered, inflated the reported time patients spent in therapy, billed for medically unnecessary services, and received kickbacks in exchange for patient referrals. USAO Western District of Texas

Connecticut dentist settles state FCA suit for $755K—Dr. George Betser has settled allegations that he submitted invoices to Connecticut’s Medicaid program for services that were never provided and for the delivery of unusable dentures. The fraud centered on patients who were residents of long term care facilities. As part of the settlement, Dr. Betser has agreed that he will not seek renewal of his expired Connecticut dental license. Connecticut Attorney General