Arthritis and Allergy Associates, a medical practice located in Torrington, Conn., will pay more than $247,000 to settle allegations that it had violated the False Claims Act by submitting false claims to Medicare, according to a Register Citizen news report.
The government has alleged that the medical practice improperly billed Medicare between 2004 and 2009 for facet joint blocks/injections to treat back pain that were not performed using real-time radiologic imaging. Medicare's policies state radiologic imaging should be utilized when performing facet joint blocks. The Medicare-enforced policies also state healthcare provider should bill for less expensive injections if the imaging is not utilized.
The government further alleged the medical practice of improperly billing Medicare for medical services provided by unlicensed individuals between 1999 and 2009. Specifically, Arthritis and Allergy Associates allegedly allowed a radiographer to administer antigens, which Medicare requires only physician or licensed non-physician practitioners to prepare and administer, according to the report.
The government investigation against Arthritis and Allergy Associates stems from a case originally filed in a whistleblower lawsuit by a former employee of the medical practice, who will receive approximately $42,000 of the recovery from the settlement under the qui tam provisions of the False Claims Act, according to the report.
Read the Register Citizen news report about the Arthritis and Allergy Associates settlement.
Read other coverage about healthcare fraud settlements:
- Pharmaceutical Company Allergan Agrees to Pay $600M for Paying Kickbacks to Physicians, Promoting Unapproved Use of Botox, Other Violations of False Claims Act
- California's El Centro Regional Medical Center to Pay $2.2M to Settle Medicare Fraud Allegations
- States' Medicaid Programs Get Piece of Johnson & Johnson Subsidiaries' More than $80M Settlement
The government has alleged that the medical practice improperly billed Medicare between 2004 and 2009 for facet joint blocks/injections to treat back pain that were not performed using real-time radiologic imaging. Medicare's policies state radiologic imaging should be utilized when performing facet joint blocks. The Medicare-enforced policies also state healthcare provider should bill for less expensive injections if the imaging is not utilized.
The government further alleged the medical practice of improperly billing Medicare for medical services provided by unlicensed individuals between 1999 and 2009. Specifically, Arthritis and Allergy Associates allegedly allowed a radiographer to administer antigens, which Medicare requires only physician or licensed non-physician practitioners to prepare and administer, according to the report.
The government investigation against Arthritis and Allergy Associates stems from a case originally filed in a whistleblower lawsuit by a former employee of the medical practice, who will receive approximately $42,000 of the recovery from the settlement under the qui tam provisions of the False Claims Act, according to the report.
Read the Register Citizen news report about the Arthritis and Allergy Associates settlement.
Read other coverage about healthcare fraud settlements:
- Pharmaceutical Company Allergan Agrees to Pay $600M for Paying Kickbacks to Physicians, Promoting Unapproved Use of Botox, Other Violations of False Claims Act
- California's El Centro Regional Medical Center to Pay $2.2M to Settle Medicare Fraud Allegations
- States' Medicaid Programs Get Piece of Johnson & Johnson Subsidiaries' More than $80M Settlement