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Center for Human Genetics and Dr. Jeffery Milunsky Agreed to Pay $798,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services with Improperly Billed Time Spans and Services that Lacked Proper Supervision

After it self-disclosed conduct to the OIG, Center for Human Genetics, Inc. (CHG) and Dr. Jeffrey Milunsky (Dr. Milunsky), Massachusetts, agreed to pay $798,993 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CHG billed for single genetic tests over multiple dates of service, determined by the time span of the tests analysis. By doing so, CHG avoided "edits" built into the computerized payment systems of the government payors which would have prevented the payment of certain specific parts of Current Procedural Terminology codes on the same date of service. The OIG further alleged that Dr. Milunsky knowingly presented or caused to be presented claims for items or services that Dr. Milunsky should have known were not provided as claimed. Specifically, CHG, under Dr. Milunsky's National Provider Number, billed for services of genetic counselors "incident to" his own professional services when those genetic counselors did not provide such services under Dr. Milunsky's direct supervision because they were not located in the same office suite or at the same address.

Action Details

  • Date:September 17, 2013
  • Enforcement Types:
    • Fraud Self-Disclosures