OIG Exclusion Screening

12-20-2019

After it self-disclosed conduct to OIG, St. Charles Health System d/b/a St. Charles Bend (St. Charles), Oregon, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that St. Charles employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

11-08-2019

On November 8, 2019, Lakeshore Diagnostic Ultrasound Co. (Lakeshore), Essexville, Michigan, agreed to be excluded for a period of five years under 42 U.S.C. 1320a-7(b)(7). OIG’s investigation revealed that Lakeshore submitted claims for Current Procedural Terminology (CPT) code 96965 for the same dates of service on which it submitted claims for CPT code 93970 or 93971. OIG contends that Lakeshore’s submission of claims for CPT code 93965 were for a procedure that was already included as a component of the duplex ultrasound procedures for which Lakeshore submitted claims using CPT codes 93970 or 93971 for the same beneficiary on the same dates of service. Senior Counsels Geoffrey Hymans and Joan Matlack, with the assistance of Program Analyst Mariel Filtz, represented OIG.

11-06-2019

On November 6, 2019, Amarillo Endoscopy Center (AEC), Amarillo, Texas, entered into a $121,550.12 settlement agreement with OIG. The settlement agreement resolves allegations that AEC employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a nursing assistant, provided items or services to AEC’s patients that were billed to Federal health care programs. Associate Counsel Dennis Pangindian represented OIG with the assistance of Paralegal Specialist Jennifer Hilton.

11-01-2019

On November 1, 2019, Eastern Area Specialty Transport, Inc., and David Haines, its owner (collectively, “EAST”), Leesburg, Ohio, agreed to be excluded for a period of five years under 42 U.S.C. 1320a-7(b)(7). OIG’s investigation revealed that EAST presented claims to Medicare Part B for ambulance transportation to and from skilled nursing facilities (SNFs) where such transportation was already covered by the SNF consolidated billing payment under Medicare Part A. OIG’s Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels David Traskey and Geoffrey Hymans with the assistance of Paralegal Specialist Jennifer Hilton, collaborated to achieve this resolution.

10-11-2019

On October 11, 2019, West Texas Multicare Clinic, P.A. d/b/a Precision Chiropractic (Precision Chiropractic), Amarillo, Texas, entered into a $10,000 settlement agreement with OIG. The settlement agreement resolves allegations that Precision Chiropractic employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a billing specialist, provided items or services to Precision Chiropractic’s patients that were billed to Federal health care programs.

10-01-2019

On October 1, 2019, Miller’s Health System, Inc. d/b/a Miller’s Merry Manor (Miller’s), Portage, Indiana, entered into a $51,489.97 settlement agreement with OIG. The settlement agreement resolves allegations that Miller’s employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a Director of Inservice Education, provided items or services to Miller’s patients that were billed to Federal health care programs.

09-26-2019

On September 26, 2019, Fredericksburg Family Practice PA d/b/a Cornerstone Clinic (Cornerstone Clinic), Fredericksburg, Texas, entered into a $53,549.66 settlement agreement with OIG. The settlement agreement resolves allegations that Cornerstone Clinic employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a medical coder, provided items or services to Cornerstone Clinic’s patients that were billed to Federal health care programs.

09-06-2019

After it self-disclosed conduct to OIG, Oak Park Place Nursing and Rehabilitation, LLC (Oak Park), Wisconsin, agreed to pay $194,354.75 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Oak Park employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

After they self-disclosed conduct to OIG, Greater Hartford Orthopedic Group, P.C. (GHOG), Connecticut, and Daryle A. Ruark, M.D. Orthopedic Surgeon, P.C. (Ruark), Massachusetts, agreed to pay $102,483.08 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that GHOG and Ruark 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 OIG, Hazelden Betty Ford Foundation (HBFF), California, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that HBFF employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

08-22-2019

After it self-disclosed conduct to OIG, U.S. Renal Care, Inc. (USRC), Texas, agreed to pay $13,171.62 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that USRC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

08-13-2019

After it self-disclosed conduct to OIG, Granite State Independent Living Center (GSILC), New Hampshire, agreed to pay $47,062.50 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that GSILC 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, Oklahoma State University Medical Trust d/b/a Oklahoma State University Medical Center (OSUMC), Oklahoma, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that OSUMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

08-05-2019

On August 5, 2019, in connection with the resolution of his False Claims Act liability, Donald R. Peterson, Overland Park, Kansas, agreed to be excluded from participation in all Federal health care programs under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that Peterson, through IVXpress, Inc., submitted claims to Medicare for infusions and/or injections that lacked the requisite direct supervision of the infusion and/or injection by a physician or nurse practitioner. Associate Counsel Dennis Pangindian represented OIG.

07-31-2019

After it self-disclosed conduct to OIG, Garfield Park Behavioral Hospital (GPBH), Illinois, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that GPBH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

07-25-2019

After it self-disclosed conduct to OIG, General Physician, P.C. (GP), New York, agreed to pay $10,957.86 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that GP employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

07-18-2019

On July 18, 2019, Richard Mintz, D.O., a physician in Dresher, Pennsylvania, agreed to be excluded from participation in all Federal health care programs for a period of 7 years under 42 U.S.C. § 1320a-7(b)(6)(B). OIG alleged that Dr. Mintz issued medically unnecessary prescriptions for opioids in exchange for cash which failed to meet the professionally recognized standards of care. Senior Counsel Lisa Veigel represented OIG.

07-12-2019

On July 12, 2019, Smith Centers for Foot & Ankle Care (SCFAC), Chicago, Illinois, entered into a $37,688.76 settlement agreement with OIG. The settlement agreement resolves allegations that SCFAC employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a medical assistant, provided items or services to SCFAC’s patients that were billed to Federal health care programs.

07-08-2019

0n July 8, 2019, in connection with the resolution of their False Claims Act liability, Damon Wade, Amy Wade, Unicare Ambulance, LLC (Unicare), and PA Paramedics LLC d/b/a Eastern Care Ambulance (PA Paramedics), Bensalem, Pennsylvania, agreed to be excluded from participation in all Federal health care programs under 42 U.S.C. § 1320a-7(b)(7). Damon Wade agreed to be excluded for a period of 10 years. Amy Wade, Unicare, and PA Paramedics agreed to be excluded for a period of 5 years. OIG alleged that Damon Wade, Amy Wade, Unicare, and PA Paramedics made repeated false statements to avoid overpayment debts to the Medicare program and to hide the fact that Damon Wade’s state paramedic license had previously been suspended because he had admitted to forging a physician’s signature. Senior Counsel Gregory Wellins represented OIG.