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Alabama Physician and Medical Practice Settles False and Fraudulent Medicare Claims Case

Stevenson Medical Center and Alan J. Wayne, M.D. (collectively, Stevenson), a Stevenson, Alabama physician and his practice that performed in-office urine drug testing, entered into a $225,000 Settlement Agreement with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services effective February 24, 2015. The Agreement resolves allegations Stevenson submitted false or fraudulent claims to Medicare. Specifically, OIG contends Stevenson submitted claims to Medicare for high and low/moderate complexity urine drug tests exceeding the number of units allowed by Medicare by using an inappropriate code to bypass computer programming that would have otherwise rejected such claims. The OIG also contends that Stevenson submitted claims for high complexity drug tests when it performed less-expensive low/moderate complexity drug tests. OIG's Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels Andrea Treese Berlin and Geoffrey Hymans, collaborated to achieve this settlement.

Action Details

  • Date:February 24, 2015
  • Enforcement Types:
    • CMP and Affirmative Exclusions