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Community Physicians of Indiana Agreed to Pay $765,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Upcoded Claims and Services for Services Not Provided as Claimed

After it self-disclosed conduct to OIG, Community Physicians of Indiana, Inc. (CPI), Indiana, agreed to pay $765,181.95 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that CPI improperly submitted claims to Federal health care programs: (1) for professional evaluation and management services using Current Procedural Terminology (CPT) codes 99212, 99213, 99214, and 99215 ("the E&M Services"); and (2) for oncology infusing services purportedly provided to the same patient on the same day as the E&M Services, where medical record documentation did not support submission of claims for both the E&M Services and oncology infusion services.

Action Details

  • Date:August 1, 2019
  • Enforcement Types:
    • Provider Self-Disclosures