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Somerset Cardiology Group Agreed to Pay $422,000 for Allegedly Violating the Civil Monetary Penalties Law for Presenting Claims for Services for Evaluation and Management Services that Were Not Provided as Claimed

After it self-disclosed conduct to OIG, Somerset Cardiology Group, P.C. (Somerset), New Jersey, agreed to pay $422,741.50 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Somerset knowingly presented claims to Medicare for items or services that it knew or should have known were not provided as claims and were false and fraudulent. Specifically, OIG contended that Somerset cloned patient progress notes, as well as improperly coded and submitted for payment to Medicare E&M services that used current procedural terminology codes to reflect a higher level of service than the cardiologists actually preformed resulting in higher payments by Medicare to which Somerset was not entitled.

Action Details

  • Date:January 7, 2016
  • Enforcement Types:
    • Fraud Self-Disclosures