Suburban Chicago Doctor and His Surgical Center to Pay More Than $750,000 to Settle False Claims Act Suit
A suburban Chicago doctor and his surgical center have agreed to pay over $750,000 to resolve allegations of submitting false claims to Medicare, announced the United States Department of Justice yesterday.
The settlement resolves a lawsuit filed under the False Claims Act, which alleged that the doctor and his surgical center knowingly billed Medicare for services not actually performed between 2013 and 2019. The lawsuit claimed that the defendants fraudulently billed for certain procedures, double-billed for others, and billed for services that were not medically necessary.
The case was investigated by the Federal Bureau of Investigation (FBI) and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). The investigation revealed evidence supporting the allegations, including patient records and billing documentation.
Under the terms of the settlement, the doctor and his surgical center will pay a total of $760,000 to the United States. In addition, the doctor has entered into a five-year integrity agreement with the Department of Health and Human Services, requiring him to engage in compliance efforts and annual reporting to ensure the prevention of future fraudulent activities.
Impact on Medicare
False claims and fraudulent billing practices can have a significant impact on Medicare, diverting funds away from legitimate medical services and compromising the integrity of the healthcare system. The settlement in this case sends a strong message that such actions will not be tolerated and will be met with serious consequences.
The settlement reached between the suburban Chicago doctor, his surgical center, and the United States highlights the government’s commitment to combating healthcare fraud. The resolution of this False Claims Act suit reinforces the importance of accurate billing practices and the need for healthcare providers to maintain the highest ethical standards in their provision of services.