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Carolyn Smith, MD Agreed to Be Excluded for 10 Years for Causing Claims to Be Submitted for Medically Unnecessary Inpatient Rehabilitation Facility Services

On April 11, 2023, in connection with the resolution of her False Claims Act liability, Carolyn Y. Smith, MD, Lafayette, Louisiana, agreed to be excluded under 42 U.S.C. 1320a-7(b)(7) for 10 years.  Dr. Smith served as Medical Director of Lafayette Physical Rehabilitation Hospital (LPRH).  OIG’s investigation revealed that Dr. Smith knowingly admitted and treated certain Medicare patients at LPRH for medically unreasonable and unnecessary inpatient rehabilitation facility (IRF) services.  Specifically, OIG alleged that Dr. Smith knowingly: (1) admitted certain patients for treatment by herself and others at LPRH whose treatment did not qualify for payment by Medicare under the IRF coverage criteria; (2) falsified records and made false statements regarding those patients for the identified IRF admissions and corresponding treatment despite the fact that neither the admissions nor the IRF services provided were medically reasonable or necessary; and (3) caused LPRH to submit claims for those IRF services to Medicare and accept payments for those IRF services from Medicare.  Senior Counsel Ellen Slavin represented OIG.

Action Details

  • Date:April 11, 2023
  • Enforcement Types:
    • CMP and Affirmative Exclusions