Tampa, Fla.-based Pulmonary Associates of Brandon has agreed to pay $419,410 to resolve allegations that it violated the False Claims Act by submitting Medicare claims for evaluation and management services that should have been billed under a lower-paying code, according to a Sept. 10 news release from the U.S. Attorney’s Office for the Middle District of Florida.
The government alleged the underlying E&M services were not medically necessary and should have been billed under a lower code from January 2017 through March 2020.
The settlement resolves a whistleblower lawsuit filed by Sheryl Turner, a former Pulmonary Associates of Brandon employee, under the False Claims Act’s qui tam provisions, which let private parties sue on the government’s behalf and share in any recovery.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
