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Illinois Physician Practice Resolves Allegations of False and Fraudulent Medicare Claims

Pain Specialists of Greater Chicago (PSGC), an Illinois physician practice that performs in-office urine drug testing, entered into a $590,763.45 settlement agreement with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services, effective September 10, 2014. The settlement resolves allegations PSGC submitted false or fraudulent claims to Medicare. Specifically, OIG contends PSGC submitted claims to Medicare for high and low/moderate complexity urine drug tests exceeding the number of units allowed by Medicare by using a code to bypass computer programming that would have otherwise rejected such claims. The OIG also contends that PSGC submitted claims for high complexity drug tests when it performed less-expensive low or moderate complexity drug tests. OIG's Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels Andrea Treese Berlin and Geoffrey Hymans, collaborated to achieve this settlement.

Action Details

  • Date:September 10, 2014
  • Enforcement Types:
    • CMP and Affirmative Exclusions