A Michigan hospice earlier this month paid more than $506,000 in civil monetary penalties (in addition to $1.9 million it had already repaid) to HHS' inspector general's office for alleged Medicare billing fraud. Starting in 1994, the Hospice of Michigan, a statewide organization based in the Detroit suburb of Southfield, allegedly billed Medicare using its higher-wage-index urban provider number for services delivered at three of its hospices in rural Ostego and Mason counties, where wages, costs and Medicare reimbursements are lower. The hospice did not admit legal guilt.
Four emergency physician groups contracting with Oklahoma City-based Emergency Physicians Billing Services earlier this month agreed to pay a total of $2.6 million to resolve allegations that the company upcoded Medicare claims on the groups' behalf. Emergency Physicians Medical Group will pay $2.35 million; MBLS Emergency Physicians will pay $87,000; Western Emergency Physician will pay $87,000; and Sierra Emergency Physicians will pay $79,000. The physician groups settled the case without admitting wrong-doing. The billing company settled with the government for $15.5 million in October 1999.
Seventy clinics and billing companies in nine states will pay $9.9 million to resolve allegations of Medicare billing fraud, the U.S. Justice Department announced early this month. The clinics and billing companies are owned or controlled by State College, Pa.-based radiologic oncologist Douglas Colkitt, M.D. The government alleged that Colkitt and his companies billed Medicare and Tricare, a military managed-care program, from 1992 to 1996 for radiation oncology services that were not provided, not ordered by a physician or not medically necessary. The Justice Department also alleged that the companies fraudulently transferred assets to avoid having to repay the government. One of the companies that has not resolved allegations against it is State College-based EquiMed and its subsidiaries.