Maryland healthcare entities agreed to settle allegations of false claims submissions to Medicare for office testing, according to the Department of Justice.
Here are three things to know.
1. The settlement agreements are as follows:
- St. Agnes Healthcare, owner and operator of Baltimore-based St Agnes hospital — $69,906.90
- Horizon Vascular Specialists, a medical practice with offices in Frederick, Germantown, Olney and Rockville — $518,479.50
- Riverside Medical Associates in Riverdale — $176,511.17
- Maryland Specialty Group in Glenn Dale — $87,393.89
- Itsuro Uchino, MD, a physician in Hagerstown — $91,476.02
2. The government alleged these entities and Dr. Uchino incorrectly billed Medicare for testing designed to assess venous sufficiency in the patient's lower body. They billed for venous Doppler duplex examination, which is part of the testing process, under the current procedural terminology code 93970, as well as for an additional test using CPT code 93965, according to the DOJ.
"CPT 93965 references an older, different technology, one that has generally been replaced by the CPT 93970 technology. Upon inquiry by the U.S. Attorney's Office and the HHS Office of Inspector General, each agreed that the billing of CPT 93965 was incorrect," the federal government said.
3. All of the accused parties denied the allegations, and liability was not determined with the settlement agreements.
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