Georgia Dermatology Practice and Owners Excluded for Default
On May 18, 2016, OIG excluded a dermatology practice headquartered in Georgia, and the practice’s two owners (collectively, “dermatology practice”), for defaulting on their payment obligations under their Settlement Agreement (Agreement) with the Department of Justice (DOJ) and OIG. The dermatology practice had previously entered into the Agreement for allegedly submitting false claims to the Medicare program that violated the False Claims Act because they: (1) were for laboratory referrals from physicians whose financial relationship with the dermatology practice violated the Stark Law, or (2) improperly included a Modifier 25 billing code on claims submitted for services provided in Georgia. The terms of the Agreement provided that the dermatology practice would make an initial upfront payment plus additional payments over a five-year period. The dermatology practice failed to make a payment in April 2016, and DOJ issued a Notice of Default to the dermatology practice on May 5, 2016. Senior Counsel Karen Glassman represented OIG.
- Date:May 18, 2016
- CMP and Affirmative Exclusions