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St. Agnes settles Medicare fraud allegations
St. Agnes settles Medicare fraud allegations
Listen to this articleSt. Agnes Healthcare will pay nearly $123,000 to settle allegations it sent false claims to Medicare to get a higher reimbursement rate for evaluation and management services, the U.S. Attorney’s Office in Maryland announced Wednesday.
Prosecutors alleged that a specialty practice with 12 cardiologists that was acquired by St. Agnes in June 2011 improperly submitted claims for services rendered for three years after the practice was acquired.
Medicare allows a higher reimbursement rate for evaluation and management services given to new patients than for services given to established patients. The cardiologists allegedly used new patient codes when it they should have used the existing patient codes, giving St. Agnes a higher reimbursement than it was entitled to under Medicare.
Wednesday’s settlement resolved a lawsuit filed under the False Claims Act filed by former St. Agnes cardiologist Jonathan Safren. The False Claims Act allows private parties who file suit on behalf of the government get a portion of the recovery money. Safren will receive $20,000 from the settlement, according to the U.S. Attorney’s Office.
