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California Physician and Practice Settle False and Fraudulent Claims Case

On June 11, 2018, James S. Dunn, Jr., MD, and James S. Dunn Jr., MD, Inc. d/b/a Auburn Urogynecology and Women's Health (collectively, "Dr. Dunn"), Auburn, California, entered into a $419,578 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. Dunn submitted claims to Medicare for items or services that he knew or should have known were not provided as claimed or were false or fraudulent. Specifically, OIG contended that Dr. Dunn submitted claims for: (1) diagnostic electromyography services using CPT Code 51784 and diagnostic anorectal manometry using CPT Code 91122 when therapeutic, not diagnostic, services had been provided; (2) pelvic floor electrical stimulation that was not preceded by a four-week course of failed pelvic muscle exercise training; and (3) pelvic floor physical therapy services that were provided by an unqualified individual. OIG's Consolidated Data Analysis Center and Office of Counsel to the Inspector General, represented by Senior Counsel Michael Torrisi, Associate Counsel Srishti Sheffner, and Associate Counsel Jonathan Culpepper, with the assistance of Paralegal Specialist Mariel Filtz, collaborated to achieve this settlement.

Action Details

  • Date:June 11, 2018
  • Enforcement Types:
    • CMP and Affirmative Exclusions