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Alabama Physician and Wife Agreed to Be Excluded for 15 Years for Submitting Claims Involving Allegedly Improper Migraine Infusions

A physician and his wife agreed to be excluded from participating in Federal health care programs for a period of fifteen years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the physician and his wife submitted claims to Federal health care programs for: (1) the treatment of migraines through the use of lengthy, multi-day dihydroergotamine (DHE) infusions, which were billed as chemotherapy and should have been provided through injection instead of infusion; and (2) office visits upcoded to a level 5 plus "prolonged services," which were not supported by the medical records and/or did not contain physician notes.

Action Details

  • Date:August 15, 2014
  • Enforcement Types:
    • CMP and Affirmative Exclusions