A Newburgh, N.Y.-based family medicine practice and its two physician owners have admitted to submitting claims for services rendered by nurse practitioners and physician assistants not enrolled with Medicare and Medicaid with no physician involvement.
Ashikkumar Raval, MD, and Manish Raval, MD, owners and operators of Orange Medical, will pay $600,000 to resolve claims they fraudulently billed Medicare and Medicaid between November 2006 and December 2022 for services that were not rendered by the physician identified in the claim, the Justice Department said Aug. 19.
The claims listed the physicians as the rendering providers, but on many occasions, they were traveling outside the country when the patient received the treatment and the providers actually giving treatment were not enrolled in Medicare or Medicaid programs.
The parties have also executed a consent judgment of more than $1.6 million, which may be enforced if they do not make the settlement payments.