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Digestive Health Partners Agreed to Pay $74,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Upcoded Drugs and Services

After it self-disclosed conduct to OIG, Digestive Health Partners, PA (DHP), North Carolina, agreed to pay $74,067.60 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that DHP submitted claims for the administration of drugs using the higher paying CPT codes for the administration of chemotherapy and other highly complex drugs or highly complex biologic agents (CPT codes 96413 and 96415), instead of the lower paying CPT codes for the administration of therapeutic drug agents, excluding chemotherapy and other highly complex drugs or highly complex biologic agents (CPT codes 96365 and 96366).

Action Details

  • Date:September 24, 2024
  • Enforcement Types:
    • Fraud Self-Disclosures