WASHINGTON (Legal Newsline) — The U.S. Department of Justice announced Jan. 19 that Scripps Health (Scripps), a health care system based in San Diego, will pay $1.5 million after allegations of improperly charging federal health care programs for certain physical therapy services in violation of the False Claims Act.

“Federal health care programs require that services are rendered by authorized providers or under the appropriate supervision of an enrolled physician,” said Chad A. Readler, acting assistant attorney general for the Justice Department’s Civil Division in a statement. “These requirements help protect patients from unscrupulous or unqualified medical professionals. The Department of Justice will continue to ensure that those who knowingly violate these requirements face appropriate consequences.”

According to the Justice Department, the physical therapy services for which Scripps billed Medicare and TRICARE were performed by therapists without proper billing privileges and were not supervised by an authorized provider.

“This settlement illustrates the U.S. Attorney’s Office’s continued commitment to protecting the integrity of the Medicare and TRICARE programs,” said U.S. attorney Adam L. Braverman in a statement.  “Unlawfully obtained payment from taxpayer-funded programs harms the entire health care system.  We will hold accountable all providers who defraud these programs.”

Handling the case for the Justice Department were the Civil Division’s commercial litigation branch, the U.S. Attorney’s Office for the Southern District of California, the Office of Inspector General for the U.S. Department of Health and Human Services, the Federal Bureau of Investigation, the Defense Criminal Investigative Service and the Defense Health Agency Program Integrity Office.   

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