Recent Exclusions for Hospitals/Medical Centers

After it self-disclosed conduct to OIG, Fort Duncan Medical Center, L.P. d/b/a Fort Duncan Regional Medical Center (FDRMC), Texas, agreed to pay $545,995.62 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that FDRMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

After it self-disclosed conduct to OIG, BHC Streamwood Hospital, Inc. d/b/a Streamwood Behavioral Health System (SBHS), Illinois, agreed to pay $285,683.03 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that SBHS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

After it self-disclosed conduct to OIG, Moses H. Cone Memorial Hospital Operating Corporation d/b/a Cone Health System (CHS), North Carolina, agreed to pay $475,220.66 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that CHS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

If you want to know if you are employing an excluded individual visit here for more information. 

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Healthcare Exclusion Screening: It’s Not Just for Hospitals- What About Imaging Companies?

Preferred Imaging, LLC, a provider of diagnostic imaging services, has agreed to pay $3,510,000 for improperly billing Medicare and Medicaid for services performed without proper medical supervision.  Preferred Imaging cooperated with the investigation and, by settling, did not admit any wrongdoing or liability.  The announcement was made July 22, 2016, by U.S. Attorney John Parker.

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Healthcare Exclusion Screening: It’s Not Just for Hospitals- What About Nursing Assistants?

On June 8, 2016, KASKA, Inc. d/b/a St. Otto’s Care Center (SOCC), Minnesota, entered into a $65,000 settlement agreement with OIG. The settlement agreement resolves allegations that SOCC employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a certified nursing assistant, provided items or services to SOCC patients that were billed to Federal health care programs.

Ophthalmologist Agrees to Pay $55,000

BOSTON – United States Attorney Carmen M. Ortiz announced that Martin E. Cutler, M.D., an ophthalmologist with offices in Woburn and Gloucester, and his company, Martin E. Cutler, M.D., P.C., have agreed to pay $55,000 to resolve allegations that they submitted false claims to Medicare.  Specifically, the government alleged that between January 2010 and December 2014, Dr. Cutler and his practice falsely billed Medicare for ophthalmic diagnostic imaging when there was no underlying diagnosis to justify the imaging.  They also allegedly falsely billed Medicare for office visits where a prior claim for the same visit had been denied and the new claim was not supported by Dr. Cutler’s documentation. 

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Latest Penalties​ Including Excluded Individual

On June 24, 2016, Simpson Chiropractic (Simpson), Oklahoma, entered into a $31,000 settlement agreement with OIG. The settlement agreement resolves allegations that Simpson employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a chiropractic assistant, provided items or services to Simpson patients that were billed to Federal health care programs. Senior Counsel Ellen Slavin represented OIG with the assistance of Paralegal Specialist Mariel Filtz.

Healthcare Exclusion Screening: It’s Not Just For Hospitals- What About Pharmacy Owners?

The owner of two northwest Alabama pharmacies has agreed to plead guilty to obstructing a Medicare audit and to pay a $2.5 million penalty to the government.

The U.S. Attorney’s Office for the Northern District of Alabama charged RODNEY DALTON LOGAN, 63, of Muscle Shoals, with one count of obstructing a 2012 federal audit of Medicare claims submitted by a pharmacy he owned. Logan, a registered pharmacist, owned Leighton Pharmacy Inc., which did business as Sheffield Pharmacy and Homecare in Sheffield, and Russellville Pharmacy in Russellville. At various times, according to the charge, Logan was the lead pharmacist at both Sheffield and Russellville. Prosecutors filed the charge by information in U.S. District Court, along with a plea agreement reached between Logan and the government.

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Healthcare Exclusion Screening: It’s Not Just For Hospitals- What About Hospice Care?

Evercare Hospice and Palliative Care will pay $18 million to resolve False Claims Act allegations that it claimed Medicare reimbursement for hospice care for patients who were not eligible for such care because they were not terminally ill, the Justice Department announced today.  Evercare, now known as Optum Palliative and Hospice Care, is a Minnesota-based provider of hospice care in Arizona, Colorado and other states across the United States.

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