Western New York Medical P.C. has agreed to pay $251,477 to settle allegations under the False Claims Act concerning improper billing practices related to Medicare. The announcement was made by Acting U.S. Attorney Joel L. Violanti.
Assistant U.S. Attorney David M. Coriell, who managed the case, explained that WNY Medical operates in Erie and Niagara Counties. The government accused WNY Medical of submitting claims for Chronic Care Management services between January 1, 2020, and March 31, 2023, without providing the required minimum of 20 minutes of clinical staff services per month as stipulated by current procedural terminology.
Acting U.S. Attorney Violanti emphasized the importance of financial integrity within the Medicare program: “The financial integrity of the Medicare program depends on providers accurately and truthfully reporting the services that they are providing.” He further stated that his office is committed to protecting this integrity by holding accountable those providers seeking payments they are not entitled to receive.
The resolution resulted from a collaborative effort between the U.S. Attorney’s Office for the Western District of New York and the U.S. Department of Health and Human Services Office of Inspector General.
It is important to note that while these claims have been resolved through settlement, there has been no determination of liability regarding these allegations.