Department of Justice – A former Maryland medical practice has paid $850,000 to resolve allegations that it submitted reimbursement claims to federal healthcare programs for evaluation and management services using fraudulent billing codes.
From 2013 to 2017, Frederick Oncology and Hematology Associates submitted claims for evaluation and management services using an inaccurate code modifier that is only appropriate when separate and distinct services are provided to a patient on the same day as a procedure or other services. Additionally, the practice routinely billed these services as if they had been performed by the patient’s physician, rather than by the non-physician provider—reimbursed at a lower rate—who had actually performed the service.
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