The lawsuit filed against American Family Care knowingly selected evaluation and management codes for a level of services that exceeded those actually provided in order to artificially increase the amount of reimbursement received for those visits, according to a Department of Justice report.
"Mischarging the government for office visits wastes valuable government resources that could be used for other patient needs," said Assistant Attorney General Stuart F. Delery in the release. "At a time of increasing concern about the cost of medical care, it is especially important to ensure that healthcare providers are not overbilling the government by improperly inflating their claims."
This civil settlement resolves a lawsuit filed by a former employee of American Family Care under the whistle-blower provision of the False Claims Act. That provision permits private parties to file suit on behalf of the government for false claims and to obtain a portion of the government recovery, according to the report.
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