False and Fraudulent Claims

Jump to: 2012, 2011, 2010, 2009

In each CMP case resolved through a settlement agreement, the settling party has contested the OIG's allegations and denied any liability. No CMP judgment or finding of liability has been made against the settling party.

2013

01-17-2013: After it self-disclosed conduct to the OIG, Paterson Community Health Center (Paterson), New Jersey, agreed to pay $100,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Paterson submitted claims for items and services furnished by an unlicensed and unregistered physician.
01-16-2013: After it self-disclosed conduct to the OIG, Bartlett Regional Hospital (Bartlett), Arkansas, agreed to pay $1,434,664.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Bartlett submitted claims using incorrect physician names and NPI numbers and submitted claims for non-physician provider services that were billed under a physician's name and NPI number.

2012

12-21-2012: After it self-disclosed conduct to the OIG, CaroMont Medical Group, Inc. (CaroMont), North Carolina, agreed to pay $205,685.27 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CaroMont presented to the United States claims for items or services that CaroMont knew or should have known were not provided as claimed and were false or fraudulent. The OIG alleged that CaroMont purchased drugs and devices from foreign sources and provided those drugs to Federal health care program patients and billed Federal healthcare programs for those products for their biochemical equivalents sold in the United States.
11-13-2012: After it self-disclosed conduct to the OIG, Community General Hospital (CGH), NY, agreed to pay $248,362.78 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CGH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-05-2012: After it self-disclosed conduct to the OIG, Essex Valley Healthcare, Inc., East Orange General Hospital, and Essex Valley Medical Transportation Services, Inc. (Respondents), New Jersey, agreed to pay $61,570.88 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the respondents employed two individuals that they knew or should have known were excluded from participation in Federal health care programs.
11-13-2012: After it self-disclosed conduct to the OIG, Community General Hospital (CGH), NY, agreed to pay $248,362.78 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CGH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.; Safeway, Inc., Wyoming, agreed to pay $56,994 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Safeway, Inc. submitted claims to Medicare Part D for the branded drug Protonix when it dispensed the authorized Protonix generic drug known as pantoprazole.
10-25-2012: After it self-disclosed conduct to the OIG, Colorado Retina Associates, P.C. and Douglas Holmes, M.D. (CRA and Dr. Holmes), Colorado, agreed to pay $71,867.58 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CRA and Dr. Holmes submitted to Federal healthcare programs claims for evaluation and management services that were not provided as claimed and were false or fraudulent.
10-12-2012: After it self-disclosed conduct to the OIG, Baptist Hospital, Inc. and Langhorne Cardiology Consultants, Inc. (Baptist and Langhorne), Florida, agreed to pay $172,604 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Baptist and Langhorne employed an individual that they knew or should have known was excluded from participation in Federal health care programs.; After it self-disclosed conduct to the OIG, Dr. Akram Abraham d/b/a Abraham Medical Clinic (Dr. Abraham), Massachusetts, agreed to pay $43,014.80 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dr. Abraham employed an individual that he knew or should have known was excluded from participation in Federal health care programs.
10-07-2012: After it self-disclosed conduct to the OIG, ABQ Health Partners, LLC (ABQ), New Mexico, agreed to pay $1,096,112 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that ABQ submitted claims to Federal health care programs for services performed by pharmacy clinicians during new and established patient visits based on E&M codes that ABQ knew or should have known were not reimbursable.; After it self-disclosed conduct to the OIG, Home Healthcare Connection, Inc. (HHCI), Kansas, agreed to pay $81,102.06 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HHCI 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 the OIG, Auburn Community Hospital (ACH), New York, agreed to pay $150,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that ACH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-05-2012: After it self-disclosed conduct to the OIG, Essex Valley Healthcare, Inc., East Orange General Hospital, and Essex Valley Medical Transportation Services, Inc. (Respondents), New Jersey, agreed to pay $61,570.88 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the respondents employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.
10-04-2012: After it self-disclosed conduct to the OIG, Duke University Health System, Inc., d/b/a Duke University Hospital (Duke), North Carolina, agreed to pay $6,395.54 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Duke employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-26-2012: After it self-disclosed conduct to the OIG, North Canton Medical Foundation (NCMF), Ohio, agreed to pay $1,018,877 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NCMF submitted claims to the Federal health care programs for podiatry services which were not supported by medical documentation.; After it self-disclosed conduct to the OIG, Salida Hospital District d/b/a Heart of the Rockies Regional Medical Center (HRRMC), Colorado, agreed to pay $120,580.25 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HRRMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-25-2012: After they self-disclosed conduct to the OIG, Discovery House LT, Inc., Discovery House UC, Inc., Discovery House TV, Inc., and Discovery House Utah, Inc. (collectively, Discovery House), Utah, agreed to pay $105,794.24 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Discovery House employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-19-2012: After it self-disclosed conduct to the OIG, East Boston Neighborhood Health Center (EBNHC), Massachusetts, agreed to pay $103,485.79 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that EBNHC 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 the OIG, Down East Community Hospital (Down East), Maine, agreed to pay $417,440.78 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Down East employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-22-2012: After it self-disclosed conduct to the OIG, Mercy Hospitals East Communities (Mercy), Missouri, agreed to pay $138,452 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Mercy employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-22-2012: After it self-disclosed conduct to the OIG, House Psychiatric Clinic, Inc. and Matthew House, D.O. (collectively House), California, agreed to pay $34,849.89 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that House billed Federal health care programs for items or services that were not provided as claimed and were false or fraudulent. Specifically, House: 1) submitted claims for services provided by four unlicensed employees as if the services were provided by Dr. House; and 2) submitted claims for services provided by a Nurse Practitioner as if those services were provided by Dr. House.
08-15-2012: After it self-disclosed conduct to the OIG, Colorado Surgical Services, PC (CSS), Colorado, agreed to pay $13,616.57 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CSS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-07-2012: After it self-disclosed conduct to the OIG, Supervalu, Inc., and its subsidiaries, FF Acquisitions, LLC, Foodarama, Inc., New Albertsons, Inc., SUPERVALU Pharmacies, Inc., and Shoppers Food Warehouse Corporation (collectively Supervalu), Minnesota, agreed to pay $184,464.03 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Supervalu submitted claims to Federal health care programs for a branded drug when it dispensed the authorized generic drug.
08-07-2012: After it self-disclosed conduct to the OIG, Mental Health Center of East Central Kansas (MHCECK), Kansas, agreed to pay $35,840 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that MHCECK improperly billed the Kansas Medicaid program for psychological services provided by a psychological testing assistant (PTA). Specifically, the PTA, who was not licensed to provide or bill for psychological evaluations, was instructed by one of MHCECK's licensed clinical psychologists (clinician) to perform psychological testing and write test interpretations and evaluation reports without the clinician ever having interviewed or seen the patients. MHCECK billed the services to Medicaid under the clinician's provider number.
08-02-2012: After it self-disclosed conduct to the OIG, Albany Memorial Hospital (AMH), New York, agreed to pay $206,669.53 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that AMH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-01-2012: After it self-disclosed conduct to the OIG, Laurence Rosenfield, M.D., P.A., and Spinal Diagnostics & Interventional Pain Medicine (SDIPM), Texas, agreed to pay $110,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dr. Rosenfield and SDIPM, through a contracted company, improperly billed Federal health care programs for services provided by a physician that did not have a Medicare provider number. The services were billed using Dr. Rosenfield's provider number.
07-24-2012: After it self-disclosed conduct to the OIG, Billings Clinic (Billings), Montana, agreed to pay $284,098.55 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Billings employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
07-25-2012: Stephan P. Babirak, Ph.D. M.D. (Babirak) and Metabolic Leader, LLC, PA (Metabolic Leader), Maine, agreed to pay $17,087.58 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Babirak and his medical practice, Metabolic Leader, improperly billed Medicare for: (1) new patient Evaluation & Management (E&M) office visits for pre-existing patients; (2) upcoded E&M office visits; and (3) services provided by nurse practitioners that were billed under Babirak's provider number when he was not in the office.
07-24-2012: After it self-disclosed conduct to the OIG, Dartmouth-Hitchcock, Vermont, agreed to pay $65,934.00 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dartmouth-Hitchcock submitted claims to Medicare and Medicaid for outpatient ambulatory clinic visits provided by a physician that were not supported by medical record documentation.
07-13-2012: After it self-disclosed conduct to the OIG, The Village of Wilkes (Wilkes), North Carolina, agreed to pay $207,440.19 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Wilkes employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
07-11-2012: Dr. Jorge Zamora-Quezada, Texas, agreed to pay $83,481.22 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dr. Jorge Zamora-Quezada employed an individual that he knew or should have known was excluded from participation in Federal health care programs.
07-06-2012: After it self-disclosed conduct to the OIG, the Treatment and Learning Centers, Inc. (TLC), Maryland, agreed to pay $28,214.16 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that TLC knowingly presented claims for items or services that TLC knew or should have known were not provided as claimed and were false or fraudulent. The OIG alleged that TLC improperly submitted claims to Medicare for services rendered by two audiologists, using the Medicare enrollment information and National Provider Identifier of a third audiologist employed by TLC.
07-05-2012: After it self-disclosed conduct to the OIG, Seasons Hospice and Palliative Care of Southern Florida, Inc. (Seasons), Florida, agreed to pay $73,428.48 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Seasons employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-27-2012: Cooperative Home Care (Cooperative), Missouri, agreed to pay $121,010 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Cooperative 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 the OIG, The Memorial Hospital at North Conway, New Hampshire (TMH) agreed to pay $20,479.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that TMH submitted upcoded claims to Medicare and Medicaid for Evaluation & Management services provided by one of TMH's physicians.
06-19-2012: Hy-Vee, Inc., Iowa, agreed to pay $831,871.61 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Hy-Vee, Inc. employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-15-2012: After it self-disclosed conduct to the OIG, Robert Jacobson Pharmacy (RJP), New York, agreed to pay $164,842.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that RJP employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-07-2012: Jennings Healthcare Center (Jennings), Indiana, agreed to pay $81,704.88 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Jennings 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 the OIG, University Eye Surgeons, P.C. (University), Tennessee, agreed to pay $19,429 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that University employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-06-2012: On With Life, Iowa, agreed to pay $77,586 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that On With Life employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
05-31-2012: After it self-disclosed conduct to the OIG, HCM Management, Inc. (HCM), Iowa agreed to pay $200,812.31 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HCM 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 the OIG, HCM Management, Inc. (HCM), Iowa, agreed to pay $200,812.31 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HCM employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.
05-10-2012: After it self-disclosed conduct to the OIG, Animas Corporation (Animas), Pennsylvania, agreed to pay $1,683,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Animas submitted reimbursement to Medicare and Medicaid for infusion pumps and supplies that were based upon documentation that included signed written orders received from physicians which had been altered without the physician's approval.
05-09-2012: Halls Physicians Services (HPS), Tennessee, agreed to pay $51,972.20 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HPS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
04-27-2012: Bloomington Podiatry Center (BPC), Indiana, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that BPC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
04-16-2012: Baypointe Nursing Home, Inc. d/b/a Baypointe Rehabilitation & Skilled Care Center (Baypointe), Massachusetts, agreed to pay $351,255.44 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Baypointe employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
04-03-2012: After it self-disclosed conduct to the OIG, Transitional Services for New York, Inc. (TSNYI), New York, agreed to pay $141,275 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that TSNYI submitted to Medicare upcoded claims for reimbursement for outpatient psychotherapy and psychiatric services.
03-26-2012: After it self-disclosed conduct to the OIG, Southern Maine Medical Center (SMMC), Maine, agreed to pay $76,529.81 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SMMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
02-22-2012: Ronald V. Myers, Sr., M.D. (Myers), Mississippi, agreed to pay $25,500 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Myers caused improper claims to be submitted to Medicare from Select Care, Inc. and Primary Physical Medicine, Inc., for physical therapy and related health care items or services that Myers did not personally render or did not directly supervise.
02-13-2012: After it self-disclosed conduct to the OIG, Reid Hospital & Health Care Services, Inc. (Reid), Indiana, agreed to pay $96,645.70 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Reid made and used false records to secure payment of false and fraudulent claims for items and services furnished under Medicare.
01-20-2012: After it self-disclosed conduct to the OIG, Senior Select Home Health Services (Senior Select), Texas, agreed to pay $41,125.51 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Senior Select knowingly presented claims for items or services that Senior Select knew or should have known were not provided as claimed and were false or fraudulent.
01-19-2012: LP Lexington Pimlico, LLC d/b/a Bluegrass Care and Rehabilitation Center (Bluegrass), Kentucky, agreed to pay $11,994.88 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Bluegrass employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
01-17-2012: Buchanan County Health Center (BCHC), Iowa, agreed to pay $406,030 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that BCHC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
01-10-2012: After it self-disclosed conduct to the OIG, Superior Medical Supply, Inc. (SMSI), Tennessee, agreed to pay $20,649.81 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SMSI employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
01-06-2012: Nathaniel Brown, M.D. (Brown), Mississippi, agreed to pay $108,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Brown caused improper claims to be submitted to Medicare from Mississippi Care Partners, Inc., for physical therapy and related health care items or services that Brown did not personally render or did not directly supervise.

2011

11-30-2011: After it self-disclosed conduct to the OIG, Evergreen Health Center, P.C. (Evergreen), Missouri, agreed to pay $83,012.58 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that one of Evergreen's independent contracting psychologists submitted claims for services not provided.
11-22-2011: After it self-disclosed conduct to the OIG, Waukesha Memorial Hospital, Inc. and ProHealth Care Medical Associates, Inc. (collectively, Waukesha), Wisconsin, agreed to pay $38,375.37 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Waukesha employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-29-2011: Mainstream Living, Inc. (Mainstream), Iowa, agreed to pay $132,925.49 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Mainstream employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
03-22-2011: After it self-disclosed conduct to the OIG, Mary Imogene Bassett Hospital d-b-a Bassett Medical Center (Bassett), New York, agreed to pay $18,084 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Bassett submitted claims to Medicare and Medicaid for a multiple view non-invasive physiologic vascular study and instead delivered a single view non-invasive physiologic vascular study.
03-21-2011: Betty J. Feir, PhD, Texas, agreed to pay $61,270 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dr. Feir submitted claims to Medicare for initial diagnostic services performed by auxiliary personnel instead of her and for services performed by auxiliary personnel while she was not present and did not provide direct supervision.
11-17-2011: After it self-disclosed conduct to the OIG, Pitt County Memorial Hospital (PCMH), North Carolina, agreed to pay $68,479.04 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PCMH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
11-14-2011: After it self-disclosed conduct to the OIG, Providence Hospital, Alabama, agreed to pay $5,938.54 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Providence Hospital employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
11-02-2011: After it self-disclosed conduct to the OIG, Sonoma Healthcare Center (SHC), California, agreed to pay $106,650.11 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SHC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
11-01-2011: Phillip L. Barnes, D.O. (Barnes), Mississippi, agreed to pay $49,419 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Barnes caused improper claims to be submitted to Medicare from Select Care, Inc. and Primary Physical Medicine, Inc., for physical therapy and related health care items or services that Barnes did not personally render or did not directly supervise.; Reginald W. Stewart, (Stewart), Mississippi, agreed to pay $88,810 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Stewart caused improper claims to be submitted to Medicare from Mississippi Care Partners, Inc. and Primary Physical Medicine, Inc., for physical therapy and related health care items or services that Stewart did not personally render or did not directly supervise.
10-26-2011: After it self-disclosed conduct to the OIG, New York City Health and Hospital Corporation (HHC), New York, agreed to pay $442,909.35 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HHC employed eight individuals that it knew or should have known were excluded from participation in Federal health care programs.
10-26-2011: After it self-disclosed conduct to the OIG, Conestoga View Nursing, L.P. d/b/a Conestoga View, Pennsylvania, agreed to pay $264,879.84 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Conestoga View employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-06-2011: After it self-disclosed conduct to the OIG, Blue Hill Memorial Hospital (BHMH), Maine, agreed to pay $40,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that BHMH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-20-2011: After it self-disclosed conduct to the OIG, Maine Coast Memorial Hospital (MCMH), Maine, agreed to pay $186,398.71 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that MCMH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-15-2011: Jenq-Sheng Liu, Jenq-Sheng Liu, M.D., P.S.C. d/b/a Blue Grass Women's Clinic, and Su-Mei Liu, (defendants), Kentucky, agreed to pay $58,952.57 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that the defendants fraudulently billed Medicaid for six different Current Procedural Terminology codes. Su-Mei Liu agreed to a five-year period of exclusion from all Federal health care programs.
09-06-2011: After it self-disclosed conduct to the OIG, Cape Cod Hospital (CCH) a subsidiary of Cape Cod Healthcare, Inc., Massachusetts, agreed to pay $115,605.36 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CCH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-06-2011: After it self-disclosed conduct to the OIG, Visiting Nurse Association of Cape Cod (VNA) a subsidiary of Cape Cod Healthcare, Inc., Massachusetts, agreed to pay $278,169.84 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that VNA employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-30-2011: After it self-disclosed conduct to the OIG, St. Joseph Health Services of Rhode Island (St. Joseph), Rhode Island, agreed to pay $123,032 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that St. Joseph employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-23-2011: Savient Pharmaceuticals, Inc. (Savient), New Jersey, agreed to pay $100,000 to resolve Civil Monetary Penalties liability under the Medicaid Drug Rebate Program. Savient failed to submit pricing information and to pay a rebate to state Medicaid programs for covered drugs that the state Medicaid programs reimburse.
08-19-2011: After it self-disclosed conduct to the OIG, Hospice of the Finger Lakes (HFL), New York, agreed to pay $35,831.70 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HFL employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-09-2011: After it self-disclosed conduct to the OIG, Kmart Corporation (Kmart), Indiana, agreed to pay $945,021.19 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Kmart employed four individuals that it knew or should have known were excluded from participation in Federal health care programs.
08-09-2011: After it self-disclosed conduct to the OIG, North American Partners in Anesthesia (NAPA), New York, agreed to pay $506,231 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that five physicians formerly associated with NAPA had furnished services at a gastroenterologist's office that inaccurately reflected procedures as having been done on two separate days when they were actually done on a single day. The false statements resulted in higher charges and caused NAPA to submit false claims in connection with those services.
07-25-2011: After it self-disclosed conduct to the OIG, Trustees of Indiana University (IU), Indiana, agreed to pay $603,522 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that IU improperly claimed services provided by third and fourth year students in its professional optometry degree program under the physician fee schedule. The services could not be properly claimed under the physician fee schedule because the students were not in a graduate medical education program and the services were not provided in a teaching hospital or teaching setting.
07-22-2011: After it self-disclosed conduct to the OIG, Health Management Services, Inc. (HMS), Louisiana, agreed to pay $6,545.61 for allegedly violating the Civil Monetary Penalties Law. Specifically, HMS disclosed the alteration of continuous positive airway pressure downloads for patients by two individuals at HMS in order to obtain Federal health care program reimbursement.
07-22-2011: After it self-disclosed conduct to the OIG, Margaret R. Pardee Memorial Hospital (Pardee), North Carolina, agreed to pay $94,729 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Pardee employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
07-18-2011: After it self-disclosed conduct to the OIG, Premier Health Care Services (PHCS), Ohio, agreed to pay $39,039 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PHCS's wholly owned subsidiary, Lucas County Emergency Physicians (LCEP), submitted false claims to Medicare and Medicaid. Specifically, while employed by LCEP, a physician provided physician services at two hospitals where he improperly billed Medicare and Medicaid under the physician fee schedule for services which were performed by residents only.
07-18-2011: After it self-disclosed conduct to the OIG, Mercy Health Partners (MHP), Ohio, agreed to pay $82,855 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that two of MHP's hospitals, St. Vincent Mercy Medical Center and St. Charles Mercy Hospital, submitted false claims to Medicare and Medicaid. Specifically, a physician improperly billed under the physician fee schedule for physician services which were performed by residents only.
06-10-2011: After it self-disclosed conduct to the OIG, Valley Obstetrics and Gynecology (VOG), Washington, agreed to pay $72,439.62 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that VOG employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-22-2011: After it self-disclosed conduct to the OIG, University of Nevada School of Medicine (UNSOM), Nevada, agreed to pay $138,321.70 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that UNSOM submitted or caused to be submitted claims for physicians' services provided by two physicians to beneficiaries of Federal health care programs using the provider identification numbers of two physicians who did not furnish the services.
06-21-2011: Daniel Herrington, the owner of One Source Medical Services a durable medical equipment (DME) company, Florida, agreed to pay $124,141.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Herrington, through the DME company, billed Medicare for custom molded diabetic shoe inserts when in fact only prefabricated inserts were provided to beneficiaries.
06-10-2011: After it self-disclosed conduct to the OIG, WellStar Cobb Hospital (WCH), Georgia, agreed to pay $9,216.73 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that WCH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-06-2011: After it self-disclosed conduct to the OIG, University of North Texas Health Science Center at Fort Worth (UNTHSC), Texas, agreed to pay $859,500 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that UNTHSC submitted claims for physicians' services provided to beneficiaries of Federal health care programs using the provider identification numbers of 103 physicians who neither furnished the service nor personally supervised the services rendered.
05-13-2011: After it self-disclosed conduct to the OIG, Internal Medicine Associates (IMA), Indiana, agreed to pay $58,573.55 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that IMA employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
05-12-2011: Beth Israel Deaconess Medical Center in Boston, Massachusetts (BIDMC) agreed to pay $233,932.54 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that BIDMC improperly billed Medicare for Lupron drug injections to male patients under HCPCS Code J1950 when BIDMC should have known that the proper code for these claims was the lower reimbursed HCPC Code J9217.
05-12-2011: Beth Israel Deaconess Hospital in Needham, Massachusetts (BIDH-N) agreed to pay $59,701.60 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that BIDH-N improperly billed Medicare for Lupron drug injections to male patients under HCPCS Code J1950 when BIDH-N should have known that the proper code for these claims was the lower reimbursed HCPCS Code J9217.
05-10-2011: After it self-disclosed conduct to the OIG, Colorado-Fayette Medical Center (CFMC), Texas, agreed to pay $50,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CFMC presented claims for items or services that it knew or should have known were not provided as claimed and were false or fraudulent.
04-29-2011: Gary Sinopoli, Jr., M.D. (Sinopoli), Mississippi, agreed to pay $133,333.16 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Sinopoli caused improper claims to be submitted to Medicare from Progressive Physical Medicine, Inc., for physical therapy and related health care items or services that Sinopoli did not personally render or did not directly supervise.; Fort Smith Regional Healthcare Foundation (Foundation), Arkansas, agreed to pay $233,000 to resolve Sparks Health System's (Sparks) liability for allegedly violating the Civil Monetary Penalties Law. The Foundation was created from the sale of Sparks and bears liability for this settlement. Sparks self-disclosed conduct to the OIG and the OIG alleged that Sparks presented claims for items that it knew or should have know were false or fraudulent.
04-06-2011: After it self-disclosed conduct to the OIG, Calvin Community, Iowa, agreed to pay $56,663 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Calvin Community employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
03-21-2011: Betty J. Feir, PhD, Texas, agreed to pay $61,270 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dr. Feir billed Federal health care programs for services provided by auxiliary personnel instead of her and for services performed by the auxiliary personnel while she was not present.
03-11-2011: Deaconess Hospital (Deaconess), Indiana, agreed to pay $76,592.52 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Deaconess employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
03-09-2011: Herman T. Palmer, M.D. (Palmer), Mississippi, agreed to pay $29,200 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Palmer caused improper claims to be submitted to Medicare from Primary Physical Medicine, Inc., for physical therapy and related health care items or services that Palmer did not personally render or did not directly supervise.
02-07-2011: Logan Emergency Ambulance Service Authority (Logan), West Virginia, agreed to pay $79,176 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Logan employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

2010

12-21-2010: Edward D. Henderson, Jr., M.D. (Henderson), Mississippi, agreed to pay $68,100 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Henderson caused improper claims to be submitted to Medicare from Primary Physical Medicine, Inc., for physical therapy and related health care items or services that Henderson did not personally render or did not directly supervise.
12-21-2010: Chadley T. Vega, M.D. (Vega), Mississippi, agreed to pay $46,200 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Vega caused improper claims to be submitted to Medicare from Primary Physical Medicine, Inc., for physical therapy and related health care items or services that Vega did not personally render or did not directly supervise.
11-24-2010: After it self-disclosed conduct to the OIG, Miami County Medical Center (MCMC), Kansas, agreed to pay $403,935.30 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that MCMC billed Medicare for physical therapy services that lacked sufficient documentation.
11-22-2010: Long Term Care, Inc. (LTC), North Carolina, agreed to pay $170,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that LTC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-20-2010: After it self-disclosed conduct to the OIG, Alliance Nursing, Inc. (Alliance), Washington, agreed to pay $14,907.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Alliance employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-18-2010: Signature Healthcare, LLC (Signature), California, agreed to pay $104,747.06 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Signature employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-30-2010: After it self-disclosed conduct to the OIG, Northeast Georgia Physicians Group, Inc. (NEGPG), Georgia, agreed to pay $64,494.92 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NEGPG billed Federal health care programs for services provided by physicians, but billed the services under the names of physicians who did not provide the services.; After it self-disclosed conduct to the OIG, Pocahontas Community Hospital (PCH), Iowa, agreed to pay $6,001.15 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PCH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-09-2010: After it self-disclosed conduct to the OIG, Mercy Medical Center and St. Alexius Medical Center (collectively the Centers), North Dakota, agreed to pay $88,331.63 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the Centers' employed the same individual that they knew or should have known was excluded from participation in Federal health care programs.
09-02-2010: After it self-disclosed conduct to the OIG, Elmhurst Outpatient Surgery Center, LLC (Elmhurst), Illinois, agreed to pay $126,525 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Elmhurst submitted false claims to Medicare for services that were not provided as claimed.
08-30-2010: After it self-disclosed conduct to the OIG, Catholic Healthcare West, Bakersfield Memorial Hospital, and Community Hospital of San Bernardino (collectively CHW), CA, agreed to pay $243,819.28 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CHW employed five individuals that it knew or should have known were excluded from participation in Federal health care programs.
08-19-2010: Hackley Professional Pharmacy, Inc. (Hackley), Michigan, agreed to pay $158,565.97 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Hackley employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-18-2010: After it self-disclosed conduct to the OIG, Beaches Open MRI of Tamarac, LLC (Beaches MRI), Florida, agreed to pay $48,384.10 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Beaches MRI employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-10-2010: After it self-disclosed conduct to the OIG, Five Star Quality Care, Inc. (Five Star), Massachusetts, agreed to pay $677,210 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Five Star employed three individuals that it knew or should have known were excluded from participation in Federal health care programs.
08-03-2010: After it self-disclosed conduct to the OIG, Middle Tennessee Medical Center, Inc. (MTMC), Tennessee, agreed to pay $19,830.94 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that MTMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
07-26-2010: After it self-disclosed conduct to the OIG, Mt. Tam Orthopedics, Inc. (Mt. Tam), California, agreed to pay $106,649.06 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Mt. Tam employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
07-09-2010: Beechwood Rehabilitation and Nursing Center (BRNC), Connecticut, agreed to pay $42,203 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that BRNC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-29-2010: After it self-disclosed conduct to the OIG, New Vista Health Services (NVHS), California, agreed to pay $86,967 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NVHS submitted false claims to the United States for blood glucose monitoring and wound care products.
06-28-1020: After it self-disclosed conduct to the OIG, Adventist Health System d/b/a Huguley Memorial Medical Center (Adventist), Texas, agreed to pay $68,831.82 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Adventist employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-25-2010: After it self-disclosed conduct to the OIG, South Pasadena Convalescent Hospital (SPCH), California, agreed to pay $142,731.56 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SPCH 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 the OIG, Highland Park Skilled Nursing & Wellness Centre (Highland), California, agreed to pay $10,640.81 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Highland employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-22-2010: After it self-disclosed conduct to the OIG, East Boston Neighborhood Health Center (EBNHC), Massachusetts, agreed to pay $200,962 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that EBNHC 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 the OIG, San Juan Regional Medical Center (SJRMC), New Mexico, agreed to pay $197,098.07 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SJRMC employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.
06-14-2010: Lake Region Lutheran Home d/b/a Heartland Care Center (Heartland), North Dakota, agreed to pay $133,973.28 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Heartland employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-11-2010: After it self-disclosed conduct to the OIG, AdCare Hospital of Worcester (AHW), Massachusetts, agreed to pay $254,820 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that AHW employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-10-2010: After it self-disclosed conduct to the OIG, University of Arkansas for Medical Sciences (UAMS), Arkansas, agreed to pay $201,689.98 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that UAMS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-04-2010: After it self-disclosed conduct to the OIG, Providence Health System � Southern California (PHS) agreed to pay $105,219.49 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PHS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
06-03-2010: After it self-disclosed conduct to the OIG, New York Downtown Hospital (NYDH) agreed to pay $220,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NYDH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
05-26-2010: After it self-disclosed conduct to the OIG, Beth Israel Deaconess Medical Center (BIDMC), Massachusetts, agreed to pay $99,787.75 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that BIDMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
05-25-2010: After it self-disclosed conduct to the OIG, South Lincoln Hospital District d/b/a South Lincoln Medical Center (SLMC), Wyoming, agreed to pay $37,736.72 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SLMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
05-20-2010: Elder Service Plan of the North Shore (ESPNS) agreed to pay $308,709.00 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that ESPNS contracted with a dentist that ESPNS should have known was excluded from participation in Federal health care programs. ESPNS participates in the Program of All-Inclusive Care for the Elderly (PACE), which receives funding from the Medicare and Medicaid programs.
05-18-2010: After it self-disclosed conduct to the OIG, Tenet Healthcare Corporation and Tenet HealthSystem KNC, Inc., (collectively Tenet), California, agreed to pay $1.9 million for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Tenet submitted claims to the Federal health care programs for clinical research-related items or services rendered at a hospital that were billed to or reimbursed by the Federal health care programs, including: 1) items or services that were paid for by clinical research sponsors or grants under which the clinical research was conducted; 2) items or services that were indicated as free of charge in the research informed consent; 3) items or services that were for research purposes only and not for the clinical management of the patient; and/or 4) items or services that were otherwise not covered under the Centers for Medicare and Medicaid Services Clinical Trial Policy.
05-17-2010: After it self-disclosed conduct to the OIG, State University of New York Upstate Medical University Hospital (SUNY), New York, agreed to pay $11,799.29 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SUNY employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
05-11-2010: After it self-disclosed conduct to the OIG, PolyMedica Corporation (PolyMedica), Florida, agreed to pay $151,963.40 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PolyMedica employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
04-29-2010: After it self-disclosed conduct to the OIG, LRG Healthcare d/b/a Lakes Region General Hospital (LRGH), New Hampshire, agreed to pay $42,900.75 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that LRGH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
04-14-2010: After it self-disclosed conduct to the OIG, Kinney Drugs (Kinney), New York, agreed to pay $8,002.95 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that a Kinney pharmacist filled unauthorized telephone prescriptions and submitted claims for those prescriptions to Medicare.; After it self-disclosed conduct to the OIG, Alpine Health Clinic (Alpine), California, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Alpine submitted false claims for services that were never provided.
04-01-2010: After it self-disclosed conduct to the OIG, La Videa Llena, Inc. (LVL) New Mexico, agreed to pay $250,078.11 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that LVL submitted false claims to the United States for oxygen services.; Robert J. Kramer and Kramer Physical Therapy Associates, Inc. (KPTA), Massachusetts, agreed to pay $122,474 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Kramer and KPTA improperly billed Medicare for physical therapy services that were not properly supervised by a licensed physical therapist.
01-13-2010: After they self-disclosed conduct to the OIG, Bel Pre Leasing Co, LLC, Liberty Leasing Co, LLC, Marlboro Leasing Co, LLC, Fayette Leasing Co, LLC, RMNH EMP, LLC, CHSI EMP, LLC, Communicare of Columbus, Inc., Prime Care Four, LLC, Regency Leasing Co, LLC, and Resident Care Consulting, LLC, Ohio, agreed to pay $135,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the entities employed two individuals that they knew or should have known were excluded from participation in Federal health care programs.

2009

12-16-2009: After it self-disclosed conduct to the OIG, The Neurological Institute, P.A., f/k/a Neurology Consultants of the Carolinas, P.A. (Institute), North Carolina, agreed to pay $181,851 for allegedly violating the Civil Monetary Penalty Law. The OIG alleged that the Institute improperly submitted claims to Medicare and Medicaid for (1) a physician's services (or an item or service incident to a physician's service) when the individual who furnished the service was not a physician; (2) services provided by a physician, when the services were not actually provided by that physician; and (3) services provided based on codes that the Institute knew or should have known would result in greater payments to the Institute than the codes applicable to the services actually provided.
11-30-2009: After it self-disclosed conduct to the OIG, Fundamental Administrative Services, LLC, THI of Kansas at Indian Creek, LLC, and Mulberry Manor, LLC, Maryland, agreed to pay $15,313.80 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that each employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
11-10-2009: After it self-disclosed conduct to the OIG, Heartland Surgical Specialty Hospital (Heartland), Kansas, agreed to pay $33,187 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Heartland employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-31-2009: After it self-disclosed conduct to the OIG, Winslow House, LLC (Winslow), Iowa, agreed to pay $9,500.51 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Winslow employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-22-2009: After it self-disclosed conduct to the OIG, University Pediatricians, Michigan, agreed to pay $91,782.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that a former physician employee of University Pediatricians failed to follow policies and procedures for claims submitted to Medicare and Medicaid for services provided by Pediatric Gastroenterology Fellows under her supervision. Specifically, the physician employee occasionally instructed Fellows to use pre-printed forms indicating that she accompanied the Fellows during patient visits. The physician employee used these forms at times when she was present during patient visits, as well as at times when she was not present.
10-16-2009: After it self-disclosed conduct to the OIG, Coram, Inc., New York, agreed to pay $72,500 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Coram, Inc. employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-15-2009: After it self-disclosed conduct to the OIG, ABCM Corporation, Iowa, agreed to pay $40,137 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that ABCM Corporation 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 the OIG, Margaretville Memorial Hospital and Margaretville Nursing Home, Inc., New York, agreed to pay $80,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Margaretville inappropriately billed Medicare Part D and State health care plans for drugs provided by Margaretville Hospital to Margaretville Nursing Home residents when the residents were covered by Medicare Part A.
09-08-2009: After it self-disclosed conduct to the OIG, Pocahontas Manor Care Center (PMCC), Iowa, agreed to pay $106,862 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PMCC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
09-11-2009: After it self-disclosed conduct to the OIG, Medicalodge of Butler (Medicalodge), Missouri, agreed to pay $67,715.26 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Medicalodge employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
08-12-2009: After it self-disclosed conduct to the OIG, Saint Vincent Medical Education and Research Institute, Inc. d/b/a Saint Vincent Medical Group (SVMG), Pennsylvania, agreed to pay $23,436.12 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SVMG employed an individual that SVMG knew or should have known was excluded from participation in Federal health care programs.
07-17-2009: After it self-disclosed conduct to the OIG, SJH Cardiac Catheterization (SJH), New York, agreed to pay $15,133 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SJH employed an individual that SJH knew or should have known was excluded from participation in Federal health care programs.
06-29-2009: Clifford Koon, Jeffrey Cowan, and William Dorvall (respondents), Florida, former owners and officers of Matrix, Diabetics, Inc. (a durable medical equipment (DME) company), agreed to pay $260,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the respondents caused Matrix to pay telemarketing firms to make unsolicited telephone calls to Medicare beneficiaries to market DME on behalf of the company. The DME company in turn submitted claims for these items for Medicare reimbursement. Section 1834(a)(17) of the Social Security Act prohibits DME suppliers from making unsolicited telephone calls to Medicare beneficiaries regarding the furnishing of a covered item, except in certain situations that were not present in this case. Section 1834(a)(17)(B) of the Act prohibits payment to a supplier who knowingly submits a claim generated pursuant to prohibited telemarketing calls.
06-17-2009: Alexander Zeuli and Physical Therapy Health Services (Respondents), Massachusetts, agreed to pay $18,532 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the Respondents improperly billed Medicare under certain CPT codes for physical therapy services when lower reimbursed codes and/or fewer units of these codes should have been billed.
06-02-2009: Ravenwood Nursing Home, Inc. (RNH), Maryland, agreed to pay $28,252.95 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that RNH employed an individual that RNH knew or should have known was excluded from participation in Federal health care programs.
05-29-2009: After it self-disclosed conduct to the OIG, National Medicare Recovery Services, Inc. (NMRS), California, agreed to pay $500,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NMRS presented or caused to be presented improper claims to Medicare for Part B wound care supplies.
05-27-2009: Claxton-Hepburn Medical Center (CHMC), New York, agreed to pay $168,597 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CHMC employed two individuals that CHMC knew or should have known were excluded from participation in Federal health care programs.
05-20-2009: Wayne Wittenberg, M.D. and his medical practice, Nature Coast Neurosurgery (Respondents), Florida, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the Respondents employed an individual that they knew or should have known was excluded from participation in Federal health care programs.
05-14-2009: After it self-disclosed conduct to the OIG, Colquitt Regional Medical Center (Colquitt), Georgia, agreed to pay $151,004.65 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Colquitt billed Medicare and Tricare for services provided by physician-assistants as if they were provided by the actual physicians.
04-21-2009: After it self-disclosed conduct to the OIG, National Medicare Recovery Services, Inc. (NMRS), California, agreed to pay $500,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NMRS presented or caused to be presented claims for Medicare Part B wound care supplies that NMRS knew or should have known would result in greater payment to NMRS's nursing home clients than the code applicable to the items actually provided.
04-02-2009: After it self-disclosed conduct to the OIG, Marquis Healthcare, Inc. (MHI), Ohio, agreed to pay $7,714.68 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that MHI employed an individual that MHI knew or should have known was excluded from participation in Federal health care programs.
03-25-2009: After it self-disclosed conduct to the OIG, St. Mary Medical Center (SMMC), Pennsylvania, agreed to pay $172,617.10 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SMMC employed an individual that SMMC knew or should have known was excluded from participation in Federal health care programs.
03-16-2009: Ediberto Soto-Cora, M.D., Texas, agreed to pay $534,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dr. Soto-Cora submitted false or fraudulent claims by using CPT codes that would generate a higher reimbursement than justified by the medical documentation or that he submitted claims without any supporting medical documentation.
03-13-2009: West Valley Imaging Limited Partnership and two physicians (West Valley), Nevada, agreed to pay $2 million and to enter into a 5-year integrity agreement for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that West Valley performed radiology tests and exams that were not ordered by Medicare beneficiaries' treating physicians.
03-11-2009: After it self-disclosed conduct to the OIG, Walgreen Louisiana Co. (Walgreen), Louisiana, agreed to pay $1,053,774.82 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Walgreen employed an individual that Walgreen knew or should have known was excluded from participation in Federal health care programs.
03-03-2009: After it self-disclosed conduct to the OIG, ShopKo Stores, Inc. (ShopKo), Utah, agreed to pay $669,824.74 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that ShopKo employed an individual that ShopKo knew or should have known was excluded from participation in Federal health care programs.
02-25-2009: After it self-disclosed conduct to the OIG, HealthWorks Rehab & Fitness, (HealthWorks), West Virginia, agreed to pay $8,132.16 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HealthWorks inappropriately billed Medicare for the performance of iontophoresis services, which is not a covered service under Medicare because it is deemed experimental.
01-06-09: Methodist Health Care-Memphis Hospitals (Methodist), Tennessee, agreed to pay $136,627 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Methodist employed an individual that Methodist knew or should have known was excluded from participation in Federal health care programs.

2008

12-29-2008: Haven Nursing Home, Inc. (Haven), Maryland, agreed to pay $90,921.06 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Haven employed an individual that Haven knew or should have known was excluded from participation in Federal health care programs.
12-12-2008: After it self-disclosed conduct to the OIG, Ellsworth Municipal Hospital (Ellsworth), Iowa, agreed to pay $46,165.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Ellsworth employed an individual that Ellsworth knew or should have known was excluded from participation in Federal health care programs.
11-18-2008: After it self-disclosed conduct to the OIG, City of Chicago, Illinois, agreed to pay $6.9 million for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the City of Chicago submitted claims to Medicare for ambulance services that were not medically necessary, billed at the wrong level of service, and submitted claims without the patient's or other appropriate person's signature as required by CMS regulations.
09-30-2008: After it self-disclosed conduct to the OIG, Skilled Healthcare LLC (Skilled), California, agreed to pay $190,746 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that eight skilled nursing facilities and one rehabilitation services contract provider for which Skilled provided administrative services, including compliance services, employed individuals that Skilled and the nine providers knew or should have known were excluded from participation in Federal health care programs. Skilled paid $190,746 on behalf of the following nine providers: Briarcliff Nursing and Rehabilitation Center LP (Texas), Pacific Healthcare and Rehabilitation Center, LLC (California), Rossville Healthcare and Rehabilitation Center, LLC (Kansas), Town & Country Manor LP (Texas), St. Elizabeth Healthcare and Rehabilitation, LLC (California), Hallmark Rehabilitation GP, LLC (California), Royalwood Care Center, LLC (California), Eureka Healthcare and Rehabilitation Center, LLC (California), and Grenada Healthcare and Rehabilitation Center, LLC (California).
09-18-2008: After it self-disclosed conduct to the OIG, Courtyard Manor of Farmington Hills (Courtyard Manor), Michigan, agreed to pay $1.7 million for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Courtyard Manor received federal health care program funds while the entity was excluded. Courtyard Manor also agreed to be excluded from Medicare, Medicaid, and all other Federal health care programs for two years in addition to its original 10-year period of exclusion.
07-26-2008: After it self-disclosed conduct to the OIG, FutureCare Irvington, LLC (FutureCare), Maryland, agreed to pay $36,290.79 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that FutureCare employed an individual that FutureCare knew or should have known was excluded from participation in Federal health care programs.
07-24-2008: Whole Health Pharmacy (WHP), Colorado, agreed to pay $100,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that WHP employed an individual that WHP knew or should have known was excluded from participation in Federal health care programs.
07-16-2008: St. Barnabas Hospital, New York, agreed to pay $132,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the hospital employed three individuals that the hospital knew or should have known were excluded from participation in Federal health care programs.
07-02-2008: Southern Illinois Healthcare Foundation (SIHF), Illinois, agreed to pay $562,021 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SIHF employed an individual that SIHF knew or should have known was excluded from participation in Federal health care programs.
06-16-2008: After it self-disclosed conduct to the OIG, Sparks Health System, Sparks Medical Foundation, and Sparks Regional Medical Center (collectively, Respondents), Arkansas, agreed to pay $1,142,973 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the Respondents billed Medicare for medically unnecessary hospital services.
05-09-2008: After it self-disclosed conduct to the OIG, Sabine County Hospital District, Texas, agreed to pay $82,341, for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Sabine fraudulently included a physician recruiting fee on its cost report as a reimbursable expense.
04-15-2008: After it self-disclosed conduct to the OIG, Biotronic West, LLC, NeuralWatch, LLC, and The Regents of the University of California, for its University of California Davis Medical Center (collectively, Respondents), agreed to pay $41,488.24 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the Respondents employed an individual that the Respondents knew or should have known had been excluded from participation in Federal health care programs.
04-03-2008: After it self-disclosed conduct to the OIG, Caritas Christi, Massachusetts, agreed to pay $250,060 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Caritas Christi employed or contracted with five individuals that Caritas Christi knew or should have known were excluded from participation in Federal health care programs.
02-01-2008: Newton Memorial Hospital (NMH), New Jersey, agreed to pay $89,279.70 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NMH employed an individual that NMH knew or should have known was excluded from participation in Federal health care programs.
01-04-2008: After it self-disclosed conduct to the OIG, Shands at Alachua General Hospital (Shands), Florida, agreed to pay $119,838 and to enter into a 3-year certification of compliance agreement for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Shands employed an individual that Shands knew or should have known had been excluded from participation in Federal health care programs.