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Specialized Physical Therapy Agreed to Pay $22,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Therapy Services Not Provided as Claimed

After it self-disclosed conduct to OIG, Specialized Physical Therapy, P.C. (SPT), Oklahoma, agreed to pay $22,635.77 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that two SPT employees submitted false and fraudulent physical therapy claims on SPT's behalf to Medicare. OIG contended that the claims submitted on behalf of SPT were false and fraudulent because (1) the services were billed as one-on-one patient/therapist encounters where group therapy services were provided; (2) the services did not accurately reflect the amount of time spent administering therapy for time based CPT codes; (3) the services were provided by a physical therapy assistant who was not properly supervised; and/or (4) some services were provided by unlicensed and unqualified individuals.

Action Details

  • Date:February 5, 2016
  • Enforcement Types:
    • Provider Self-Disclosures