Providers Plead Guilty to Fraudulent Billing Scheme


A co-owner and medical director of a pain management clinic admitted he, a billing supervisor, and others conspired to submit fraudulent claims indicating that minor surgical procedures occurred on days subsequent to office visits when, in fact, the office visits and procedures took place on the same day. He admitted that this practice, commonly referred to as “unbundling,” was done to defraud Medicare and other health care insurers for nonreimbursable office visits. He further admitted to falsifying and directing others to falsify records substantiating the fraudulent claims. Read a Department of Justice press release.



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