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Stipulated Penalties and Exclusion for Material Breach

The summaries listed below represent recent cases in which the OIG imposed Stipulated Penalties for non-compliance with the requirements of a CIA/IA or exclusion for a Material Breach of a CIA/IA.

11-04-2016
Missouri Hospital Management Company and Owner Pay CIA Stipulated Penalty
On November 4, 2016, SpecialCare Hospital Management Corporation and Robert McNutt (collectively, SpecialCare) paid a stipulated penalty of $30,000 for SpecialCare's failure to conduct legal review of new, renewed, and existing Focus Arrangements during the first Reporting Period and to timely submit its first Annual Report as required by its CIA with OIG.
09-13-2016
Kindred Healthcare Pays CIA Stipulated Penalty
On September 13, 2016, Kindred Healthcare, Inc. (Kindred), paid a Stipulated Penalty in the amount of $3,073,961.98. Press Release.
02-23-2016
Maryland Cardiology Practice and Physicians Pay IA Stipulated Penalty
On February 23, 2016, Advanced Cardiology Care, Mubashar Choudry, M.D., and Moshin Ijaz, M.D. (collectively, ACC) paid a stipulated penalty of $2,800 for ACC's failure to timely submit its second Annual Report as required by its IA with the OIG.
02-10-2016
North Carolina Physician Pays IA Stipulated Penalty
On February 10, 2016, John Sunghoon Won, D.D.S., M.D. paid a Stipulated Penalty of $10,000 based on his failure to comply with the following IA requirements: (1) post in a prominent place accessible to all patients and Covered Persons, a notice that provides the HHS OIG Fraud Hotline telephone number; (2) provide to all Covered Persons at least one hour of training within 60 days of the Effective Date of the IA; (3) screening of employees and contractors against the OIG and GSA exclusion lists; and (4) late submission of his Implementation Report.
11-15-2015
OIG Excludes Todd Roberts and his Practice for Material Breach
On November 15, 2015, OIG excluded Todd Roberts and Roberts Physical and Aquatic Therapy, LLC a/k/a Roberts Physical Therapy and Wellness Center, LLC (collectively, Roberts), for a period of six years based on a material breach of its Corporate Integrity Agreement (CIA). During the first reporting period of its CIA, Roberts' Independent Review Organization (IRO) identified an overpayment of $32,295, which Roberts has not paid. Roberts also failed to timely submit its Implementation Report, First Annual Report, and Second Annual Report. On June 16, 2014, OIG issued a letter demanding stipulated penalties in the amount of $24,000. OIG issued a notice of material breach and intent to exclude on September 1, 2015 for repeated and flagrant violations of the CIA and Roberts' failure to respond to OIG's demand letter. On October 15, 2015, OIG sent Roberts an exclusion letter. Under the terms of the CIA, Roberts had 25 days to request a hearing with an Administrative Law Judge. Roberts did not request a hearing, and the exclusion went into effect on November 15, 2015. Senior Counsels Lee Penninger, Tamara Forys, and Lauren Marziani represented OIG.
11-05-2015
OIG Excludes Georgia Pain Management Clinic for Material Breach
On November 5, 2015, OIG excluded C.F. Health Management, Inc. d/b/a/ Gainesville Pain Management (Gainesville), for a period of five years, based on a material breach of its Corporate Integrity Agreement (CIA). During the first reporting period of its CIA, Gainesville's Independent Review Organization (IRO) identified an error rate of 28% in its Discovery Sample and an error rate of 37.98% in its Full Sample, resulting in an extrapolated overpayment of $239,961.80. On July 16, 2015, OIG issued a letter demanding stipulated penalties in the amount of $34,000 based on Gainesville's failure to repay the overpayment identified by its IRO. After Gainesville failed to respond to OIG's demand letter, OIG issued a notice of material breach and intent to exclude on August 21, 2015. Under the terms of the CIA, Gainesville had 25 days to request a hearing with an Administrative Law Judge. Gainesville did not request a hearing and the exclusion went into effect on November 5, 2015. Senior Counsel Nicole Caucci represented OIG.
08-07-2015
Florida Physician Pays IA Stipulated Penalty
On August 7, 2015, Dr. Steven Chun and Sarasota Pain Associates, P.A. paid a Stipulated Penalty of $20,000.00 for his late submission of his first Annual Report. The report was submitted 61 days past the due date.
05-15-2015
Renal Dialysis Company Pays CIA Stipulated Penalty
On May 15, 2015, Davita Healthcare Partners, Inc. paid a Stipulated Penalty in the amount of $450,000.00 for its failure to comply with certain CIA requirements, including Focus Arrangements Procedures and Focus Arrangements Requirements, Notice to Joint Venture Partners and Medical Directors, and Disclosure Program.
04-15-2015
Florida Physician Pays IA Stipulated Penalty
On April 15, 2015, Dr. Steven Chun and Sarasota Pain Associates, P.A. paid a Stipulated Penalty of $4,000, based on his late submission of his third Quarterly Claims Review Report.
10-03-2014
Florida Physician Pays IA Stipulated Penalty
On October 3, 2014, Dr. Steven Chun and Sarasota Pain Associates, P.A., paid a Stipulated Penalty of $8,050, based on his failure to timely implement several requirements of his IA with the OIG, including providing training, retaining and Independent Review Organization (IRO), and screening Covered Persons against the OIG and GSA exclusion lists, and his failure to timely submit an Implementation Report.
09-18-2014
OIG Issues Demand for Stipulated Penalty to Louisiana Nursing Home Chain
On September 18, 2014, OIG issued a demand for a $25,000 Stipulated Penalty against Foundation Health Services, Inc. (Foundation), based on its failure to timely retain an Independent Quality Monitor as required by its CIA with the OIG. Foundation appealed the Stipulated Penalty demand to an Administrative Law Judge and the Stipulated Penalty was later withdrawn after Foundation retained a Quality Monitor and agreed to a two-month extension of its CIA.
06-17-2014
Florida Sleep Lab Pays CIA Stipulated Penalty
On June 17, 2014, American Sleep Medicine, Inc. paid a Stipulated Penalty of $5,000 for its failure to disclosure two Reportable Events that involved probable violations of the Anti-Kickback Statute, as required by its CIA with the OIG.
06-09-2014
Florida Medical Device Company Pays CIA Stipulated Penalty
On June 9, 2014, Exactech, Inc. (Exactech) paid a Stipulated Penalty of $15,000 based on its failure to comply with the following CIA requirements (1) screening of employees and contractors against the OIG and GSA exclusion lists, (2) failure to distribute or make available new or revised policies and procedures, and (3) failure to provide parties to Focus Arrangements with a copy of Exactech's Code of Conduct and Anti-Kickback Statute policies and procedures.
06-04-2014
Puerto Rico Physician Pays IA Stipulated Penalty
On June 4, 2014, Dr. Salvador Ribot Ruiz and Policlinica Dr. Salvador Ribot Ruiz, Inc. (collectively, Dr. Ruiz) paid a Stipulated Penalty of $6,300 for his failure to engage a new Independent Review Organization (IRO) within 60 days of terminating his previous IRO, as required by Dr. Ruiz's IA with the OIG.
03-13-2014
Maryland Practice Management Company Issued CIA Stipulated Penalty Demand
On March 13, 2014, OIG issued a demand for Stipulated Penalties in the amount of $24,000 to Imagimed, LLC (Imagimed) for its failure to timely submit an Implementation Report required by its CIA with the OIG. Imagimed filed for bankruptcy and, therefore, did not pay the Stipulated Penalty.
03-07-2014
Notice of Exclusion Issued to Tennessee Dental Practice Management Company
On March 7, 2014, OIG issued a Notice of Exclusion to Church Street Health Management (CSHM), pursuant to the Breach and Default provisions of CSHM's CIA, based on numerous material breaches of the CIA and CSHM's failure to cure those breaches. Specifically, on December 6, 2013, OIG issued a Notice of Material Breach and Intent to Exclude Church Street Health Management (CHSM) for the company's failure to comply with the provisions of its Corporate Integrity Agreement relating to: (1) implementation of policies and procedures, (2) reporting Quality of Care Reportable Events, (3) maintaining a Disclosure Log, (4) hiring Regional Dental Directors and performing onsite reviews, and (5) refunding overpayments to Federal health care programs. Also, on January 7, 2014, OIG issued a Notice of Material Breach and Intent to Exclude Church Street Health Management (CHSM) for its failure to comply with the provisions of its CIA relating to: (1) conducting training and education of Covered Persons, (2) submitting false certifications from employees regarding compliance with Federal health care program and CIA requirements, (3) reporting Quality of Care Reportable Events, (4) reporting and refunding overpayments to Federal health care programs, (5) establishing a Disclosure Program and maintaining a Disclosure Log, and (6) developing, distributing and implementing policies and procedures. News Release
12-10-2013
Massachusetts Pain Management Doctor Pays IA Stipulated Penalty
On December 10, 2013, Anil Kumar, M.D., Advanced Pain Management, Inc. and Northwest Ambulatory Center, Inc. (collectively, Kumar) paid a Stipulated Penalty of $5,000 for its failure to designate and maintain a Compliance Contact as required by Kumar's IA with the OIG.
03-04-2013
California Hospital Pays CIA Stipulated Penalty
On March 4, 2013, Tulare District Hospital (Tulare) paid a Stipulated Penalty of $105,000 based on Tulare's failure to comply with the Arrangements Procedures and Focus Arrangements Requirements of its CIA with the OIG.

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