Temple University Physicians, a physician faculty practice at Philadelphia-based Temple University School of Medicine, agreed to pay $1.9 million to settle Medicare billing fraud allegations, the U.S. Attorney in Philadelphia announced Monday.
The civil settlement stemmed from an ongoing investigation by the HHS' inspector general's office known as the Physicians At Teaching Hospitals, or PATH, initiative.
The government alleged that the Temple doctors billed Medicare for procedures unsupported by documents and illegally upcoded services. At the core of the PATH investigation is the allegation that faculty physicians submitted claims as though they performed the services themselves, when medical residents or interns actually treated the patients. The original Temple audit was conducted from Medicare Part B claims submitted in 1995-1996. Since 1995, 20 teaching hospitals have paid $131 million to settle PATH allegations, while another 16 have paid $94.8 million to resolve PATH-like charges, for a total of $225.8 million.
"Through this settlement we are protecting the integrity of the Medicare system on which our senior citizens depend for their critical health care coverage," U.S. Attorney Patrick Meehan said in a news release. "This settlement, and others, is intended to correct improper past behavior and to ensure that the physician submitting the claim to Medicare actually rendered the service."
In signing the 14-page settlement, Temple University Physicians, part of the three-hospital, 916-bed Temple University Health System, refuted the allegations. "Temple officials denied any wrongdoing but, to avoid lengthy and costly litigation, decided to settle," Temple said in a news release. "The quality of care was never at issue, but rather whether the complex Medicare billing rules were followed."
Assistant U.S. Attorney Margaret L. Hutchinson and Greg Wellins of the HHS' inspector general's office led the investigation.