Settlement reached in Medicare fraud case
Peter D. Leary
Special PhotoFrom staff reports
MACON – A civil settlement has been reached with Infectious Disease Consultants of Georgia, an infusion clinic with six outpatient locations in the greater Atlanta area.
IDC agreed to pay $325,000 to the United States to resolve allegations that it violated the False Claims Act by submitting bills to the Medicare program for infusion services provided by unlicensed or otherwise unapproved individuals. The settlement marks the end of a yearslong investigation into IDC’s billing practices that began with a qui tam case filed in the Middle District of Georgia.
“We are committed to protecting the public trust and will carefully investigate allegations of fraud in pursuit of this mission,” acting U.S. Attorney Peter D. Leary said in a news release. “I want to thank the U.S. Department of Health and Human Services for their work investigating these allegations, and I also want to thank IDC for cooperating fully during the investigation and resolution of these claims.”
“To ensure patients receive quality care and taxpayer-funded federal health care programs are properly billed, Medicare only pays for medical services provided by licensed, credentialed and approved professionals. Therefore, we will continue to investigate allegations of unapproved providers billing federal health care programs,” Derrick L. Jackson, special agent in charge for the Office of Inspector General of the U.S. Department of Health and Human Services, said. “We are proud to work with the U.S. Attorney’s Office staff to investigate this case and also acknowledge IDC for fully cooperating during the investigation and resolution of this matter.”
Federal health care programs, such as Medicare, allow infusion services to be provided and billed only when they are provided by certain licensed and approved providers. The alleged scheme in this case concerned IDC’s submission of claims to Medicare for infusion services improperly rendered by unlicensed or otherwise unapproved individuals. IDC fully cooperated during the investigation, after which the parties agreed to resolve the allegations described herein. The claims covered by the settlement are allegations only, and there has been no determination of liability.
The case was investigated by Special Agent Shawn McAleer of the U.S. Department of Health and Human Services — Office of Inspector General, and Investigator Shaketia Morgan, formerly of the U.S. Attorney’s Office for the Middle District of Georgia. The government’s civil settlement was reached by Assistant U.S. Attorney Bowen Reichert Shoemaker.
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