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Advanced Urogynecology, Florida Woman Care, and FWC Urogynecology Agreed to Pay $444,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting False Claims Associated with Pelvic Floor Therapy

On July 13, 2020, Advanced Urogynecology, LLC, Florida Woman Care, LLC, and FWC Urogynecology, LLC (collectively, “FWC”), with multiple locations in Florida, entered into a $444,591.16 settlement agreement with OIG. The settlement agreement resolves allegations that FWC submitted claims to Medicare for items or services rendered by Dr. Kristin Jackson at Advanced Urogynecology, LLC that it knew or should have known were not provided as claimed and were false or fraudulent. Specifically, OIG contended that FWC submitted claims for: (1) diagnostic electromyography services using CPT Code 51784 and diagnostic anorectal manometry services using CPT Code 91122 when therapeutic services, not diagnostic services, had been provided; (2) pelvic floor physical therapy services using CPT Codes 97032, 97110, and 97750 when those services were provided by unqualified individuals; (3) biofeedback therapy using CPT Code 90911 that was not preceded by a four-week course of failed pelvic muscle exercise training; and (4) evaluation and management (E&M) services using CPT Code 99211 when no separate and identifiable E&M services were provided. OIG’s Division of Data Analytics and Office of Counsel to the Inspector General, represented by Senior Counsels Srishti Sheffner and Michael Torrisi with the assistance of Program Analyst Mariel Filtz and Chief Investigator Amber Mahmood, collaborated to achieve this resolution.

Action Details

  • Date:July 13, 2020
  • Enforcement Types:
    • CMP and Affirmative Exclusions