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Mary Free Bed Medical Group Agreed to Pay $69,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Upcoded Services

After it self-disclosed conduct to OIG, Mary Free Bed Medical Group (MFB), Michigan, agreed to pay $69,677.70 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that MFB submitted false, up-coded claims to Medicaid and Medicare for pediatric outpatient evaluation and management services using CPT codes 99204 through 99215, where a doctor was the rendering provider and documented a higher level of care and more face-to-face patient time and/or collaboration with the patients’ care team then the doctor actually provided.

Action Details

  • Date:August 21, 2024
  • Enforcement Types:
    • Fraud Self-Disclosures