Albert Einstein Healthcare Network, Medicare Fraud, Pennsylvania 2010

Medicare Fraud Rocks Albert Einstein Healthcare Network in Pennsylvania

A shocking case of Medicare fraud has come to light in Pennsylvania, involving the Albert Einstein Healthcare Network and the Einstein Practice Plan. According to a recent settlement, these healthcare entities have agreed to pay a whopping $968,418.60 to resolve allegations of improperly billing Medicare for services submitted on behalf of a cardiologist.

The allegations, which date back to October 15, 2010, and January 9, 2012, claim that the cardiologist's services were not medically necessary or lacked sufficient documentation, resulting in overpayments to Einstein. The United States alleges that false claims were submitted to the government.

Fortunately, the Einstein defendants took corrective action to resolve the improper payments and promptly disclosed the matter to the United States Attorney's Office. This self-disclosure and subsequent investigation led to the discovery of the problem and the subsequent settlement.

The individuals responsible for handling this matter include Katherine Matos from the Department of Health and Human Services Office of the Inspector General, as well as Susan Dein Bricklin and George Niedzwicki.

The cardiologist in question is no longer employed by the Einstein defendants, which is a positive outcome in light of this Medicare fraud case.

In a statement regarding the settlement, it was noted that the Einstein defendants voluntarily disclosed the allegations and took corrective action, demonstrating a commitment to transparency and compliance with Medicare regulations.

The $968,418.60 payment is a significant sum, and it serves as a reminder of the importance of accurate billing and documentation in the healthcare industry.

Source: https://www.justice.gov/usao-edpa/pr/albert-einstein-healthcare-network-and-einstein-practice-plan-agree-settlement