Dr. Scott Saffold of Virginia Beach and his practice, Chesapeake Bay ENT, P.C., have agreed to a $625,000 settlement in a civil fraud case. The allegations involved false billing practices related to government healthcare programs.
The United States and the Commonwealth of Virginia accused Dr. Saffold and Chesapeake Bay of charging for unnecessary balloon sinus dilations. It was alleged that these procedures were performed on multiple sinuses without medical necessity and staged over separate times to increase reimbursements from government payors. Additionally, it was claimed that they billed for endoscopies with sphenoid sinusoscopy under a specific code when not actually performing those procedures.
This settlement is linked to a lawsuit filed under the whistleblower provision of the False Claims Act. Such actions allow individuals to file complaints confidentially in federal court while providing evidence to the U.S. Attorney’s Office for investigation. The Act also offers whistleblowers a portion of any government recovery.
The resolution resulted from collaboration between several entities including the U.S. Attorney’s Office for the Eastern District of Virginia, Health and Human Services Office of Inspector General, Department of Defense Office of Inspector General's Defense Criminal Investigative Service, and Virginia’s Office of the Attorney General.
Assistant U.S. Attorney Clare Wuerker managed this matter alongside Senior Assistant Attorney General Kristin Gray and Assistant Attorney General Airen Adamonis from the Virginia Medicaid Fraud Control Unit.
The press release can be accessed on the website of the U.S. Attorney’s Office for the Eastern District of Virginia, with case records available on PACER under case number 2:18cv435.
It is important to note that these settled claims are merely allegations with no determination made regarding civil liability.