California urology practice to pay $1.85 million over alleged false Medicare claims

By Marian Johns | Mar 5, 2019

WASHINGTON (Legal Newsline) - A California urology practice has reached a $1.85 million settlement with the federal government over allegations of submitting false Medicare claims for evaluation and management services. 

According to the U.S. Department of Justice (DOJ), Skyline Urology allegedly submitted false claims to Medicare for services that were not allowed under the Medicare program and "improperly bundled" services that would not have been "separately billable." Skyline's actions resulted in the company receiving improper Medicare compensation, the DOJ said. 

“The U.S. Attorney’s Office for the District of Maryland is committed to thoroughly investigating claims of fraud and holding health care providers accountable when they break the rules,” U.S. Attorney Robert Hur said in a statement. “This settlement is an example of how whistleblowers and government can work together to recoup and deter overbilling practices.”

“Providers are expected to closely follow Medicare rules and bill properly — nothing more, nothing less,” added Maureen Dixon, office of the inspector general for the U.S. Department of Health and Human Services special agent in charge. “Taxpayer money wasted is money stolen from this vital federal health program.”

Skyline has also reached an integrity agreement with the U.S. Department of Health and Human Services' Office of the Inspector General that will involve monitoring of Skyline's billing process, according to the department. 

The settlement stems from a whistleblower lawsuit filed in the District of Maryland by a consulting firm founder who will receive more than $300,000 as part of the settlement, the DOJ said. 

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