The University of Texas Health Science Center at Houston Agreed to Pay $390,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Upcoded Evaluation and Management Claims

After it self-disclosed conduct to OIG, The University of Texas Health Science Center at Houston (UTHSC), Houston, Texas, agreed to pay $390,853.86 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that UTHSC submitted claims for evaluation and management (E/M) services performed by a physician as level 4 or 5 when a lower level of service was provided. OIG further contended that UTHSC billed for E/M services performed by the physician when he only performed a procedure during the visit and, in fact, no separately identifiable, medically necessary E/M services were provided.