Ruth M. Rothstein CORE Center Agreed to Pay $101,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services that Were Improperly Supervised and Services Rendered Outside a Scope of Practice

After it self-disclosed conduct to OIG, Ruth M. Rothstein CORE Center, a registered department of John H. Stroger, Jr. Hospital of Cook County (The CORE Center), Illinois, entered into a $101,293.51 settlement agreement with OIG. The settlement agreement resolves allegations that The CORE Center improperly billed Medicare under the physician fee schedule for evaluation and management services provided by residents. These claims were improper because the supervising physicians did not directly supervise the residents and did not meet the primary care exception to Medicare’s direct supervision requirements. Further, OIG alleged that The CORE Center billed Federal health care programs for services provided by a pharmacist incident to a physician that were outside the scope of pharmacy practice in the State of Illinois, and thus not billable to Federal health care programs.