After lots to report last week in terms of lab-related enforcement actions, things have slowed down again, with most recent actions dealing with other areas of the healthcare industry, including transportation, personal care, and a doctor settling False Claims Act (FCA)-related allegations.
Nov. 23: An Illinois-based ambulance services company, HealthOne Critical Care Transport Service, Inc. d/b/a MedicOne Medical Response (MedicOne), settled allegations of improper billing for $302,124.37, according to the U.S. Department of Justice (DOJ). According to the DOJ, MedicOne allegedly billed Medicare for routine, non-emergency transportation of patients, sometimes even billing the federal healthcare insurance plan for instances when patients used their own or other forms of transportation to get to social outings and routine medical appointments.1
Nov. 28: A former personal care worker from Maryland pled guilty to healthcare fraud that cost the DC Medicaid program more than $700,000. Between December 2014 and February 2022, Joseph Tamjong, 51, worked in DC as a “personal care aid and/or a participant-directed worker,” according to the DOJ. However, he faked timesheets showing that he provided such services when, in reality, he did not. He even billed Medicaid for roughly “3,400 hours of services that he purportedly provided when he actually was traveling internationally,” the DOJ said in a statement. As part of Tamjong’s guilty plea, he has agreed to fork over $733,405 in restitution and $396,155 in a forfeiture money judgment. Scheduled to be sentenced in early March 2023, he also faces up to 10 years in prison.2
Nov. 28: A Pennsylvania doctor settled FCA-related allegations for $86,506.30. According to the DOJ, Dr. Musaddiq Nazeeri was accused of violating the FCA by billing for services that were not properly documented in medical records. Between February 10, 2021 and January 21, 2022, Nazeeri billed for evaluation & management (E&M) services, but medical records only showed the administration of the COVID-19 vaccine in those cases, the DOJ alleges, adding that the doctor “cooperated with the investigation.” E&M services are those related to the diagnosis and treatment of injuries or illnesses.3
References:
- https://www.justice.gov/usao-sdil/pr/ambulance-company-settles-allegations-billing-medicare-unnecessary-non-emergency
- https://www.justice.gov/usao-dc/pr/maryland-man-pleads-guilty-defrauding-medicaid-more-700000-scheme-involving-personal-care
- https://www.justice.gov/usao-mdpa/pr/medical-doctor-pay-8650630-resolve-civil-liability-alleged-violations-false-claims-act