LEXINGTON, Ky. – Lexington-based podiatry practice Lexington
Foot and Ankle Center, PSC (“Lexington Foot & Ankle”) and Dr. Michael Allen
have agreed to resolve civil allegations that they violated the False Claims
Act, a federal law that prohibits the submission of false or fraudulent claims
to the federal government, agreeing to pay the United States $750,000.
The agreement resolves a civil lawsuit filed by the United
States against Lexington Foot & Ankle and Dr. Allen, on November 28,
2018. In the lawsuit, the United States
alleged that Lexington Foot & Ankle, at Dr. Allen’s direction, submitted
false claims to Medicare and the Federal Employee Health Benefits Program,
seeking payment for nail debridement services, for which podiatrists or other
practitioners either did not assess or observe medical necessity or only
performed less involved procedures. The
lawsuit alleged that the defendants nevertheless submitted reimbursement claims
for nail debridements, which are reimbursed at a higher rate. The United States
further alleged that Lexington Foot & Ankle and Dr. Allen created cloned
(or nearly identical) patient records, in order to secure reimbursement for the
false debridement claims.
In addition to the monetary payment, the defendants have
also agreed to submit to an integrity agreement with the Office of Inspector of
the Department of Health and Human Services (HHS-OIG), which will require
additional review of their Medicare claims over a five-year period.
This case was investigated by HHS-OIG and the Office of the
Inspector General of the Office of Personnel Management. Assistant United
States Attorneys Carrie Pond and Mary Melton represented the United States.
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