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Dr. Scot Richardson and Southern California Head Pain and Neurologic Institute Agreed to Pay $499,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services that Were Not Rendered or Were Medically Unnecessary

On October 19, 2022, Scot J. Richardson, M.D. and Southern California Head Pain and Neurologic Institute, Inc. (collectively, “Dr. Richardson”), Ventura, CA, entered into a $499,260.94 settlement agreement with OIG.  The settlement agreement resolves allegations that Dr. Richardson submitted claims: (1) using CPT code 95937 (neuromuscular junction (NMJ) testing) under Scot J. Richardson, M.D.’s National Provider Identifier (NPI) number when the NMJ testing was either not medically necessary or was not performed at the applicable standard of care; and (2) using CPT code 95913 (for thirteen or more nerve conduction studies (NCS)) under Scot J. Richardson, M.D.’s NPI number when he only performed twelve or fewer NCS.  OIG's Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsel Srishti Sheffner and Deputy Branch Chief Geoffrey Hymans, collaborated to achieve this resolution.

Action Details

  • Date:October 19, 2022
  • Enforcement Types:
    • CMP and Affirmative Exclusions