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Illinois Diagnostic Services Provider Settles Case Involving False Claims

On October 30, 2018, Cal-Devon Urgent Care, Inc. (CDUC), Chicago, Illinois, entered into a $224,151.48 settlement agreement with OIG. The settlement agreement resolves allegations that CDUC submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 96965 when those claims were for a procedure that was already included as a component of the duplex ultrasound procedures for which CDUC submitted claims using HCPCS codes 93970 or 93971 for the same beneficiary on the same dates of service. The OIG further contends that the submission of claims for HCPCS code 93965 were for a procedure that should not have been separately billed and was not medically necessary. Senior Counsels Geoffrey Hymans and Joan Matlack, with the assistance of Program Analyst Mariel Filtz, represented OIG.

Action Details

  • Date:October 30, 2018
  • Enforcement Types:
    • CMP and Affirmative Exclusions