San Diego Retina Associates’ Mark Smith, MD, and Fane Robinson, MD, were accused of billing Medicare for services provided by a physician who was not properly credentialed at the time.
Federal prosecutors also alleged that the physicians misidentified another SDRA physician who treated a Medicare patient, then received illegal Medicare payments resulting from that claim.
The settlement stems from a whistleblower lawsuit brought by Atul Jain, MD, an ophthalmologist and former partner at SDRA. Dr. Jain will receive $170,778.27 of the $948,768.18 settlement.
More articles on coding, billing and collections:
The ASC as a Revenue Generator: How to optimize out-of- network reimbursements
Cigna drops Dignity Health after contract negotiations fail — 4 insights
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