S.D. AG announces Medicaid settlement with doctor

By Bryan Cohen | Jan 29, 2013

PIERRE, S.D. (Legal Newsline) - South Dakota Attorney General Marty Jackley announced a settlement Tuesday with a Sioux Falls doctor who allegedly submitted partially inaccurate claims to Medicaid for reimbursement.

Annette M. Bosworth allegedly submitted reimbursement claims to Medicaid for services provided with the assistance of a physician assistant without an approved supervision agreement to practice and submitted claims for non-covered services.

The non-covered services involved the provision of treatments of Venofer to patients who were under the age of 19. Bosworth did not indicate in the patients' records that oral iron therapy was rejected prior to the administration of Venofer.

Under the terms of the settlement, Bosworth will pay $14,790.32 to the state, offset by the total amount of eligible suspended Medicaid claims of $9,260.98. Bosworth will pay the net difference of $5,529.34. Federal law require states to suspend Medicaid payments to providers while overpayment cases are pending.

The settlement is neither an admission of liability or wrongdoing, nor is it a concession by the state that its claims are not well founded.

"As with any Medicaid payment issue, we work with the provider to resolve the matter without litigation when possible," Jackley said. "In this case, we were able to ensure that Medicaid funds were properly utilized, while treating the provider fairly."

The settlement will fully reimburse the Medicaid program for the covered claims.

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