Compliance News Roundup: OIG’s Medicare Compliance Review of Mobile Infirmary Medical Center

1. Vascular Access Centers to Pay at Least $3.825 Million to Resolve False Claims Act Allegations – “Medicare patients with End Stage Renal Disease, like other beneficiaries, are entitled to receive care in accordance with their clinical needs and not based on the financial interests of healthcare providers,” said Assistant Attorney General Joseph H. Hunt for the Department of Justice’s Civil Division. “Entities and individuals that attempt to profit through improper financial incentives and thereby bypass independent clinical decision-making will be held accountable.” Get the full scoop >>

2. Government files False Claims Act complaint against ophthalmologist, Dr. Aarti D. Pandya – “The government intervened and filed a complaint in a False Claims Act lawsuit against Aarti D. Pandya, M.D. a/k/a Arati D. Pandya, M.D., an ophthalmologist from Conyers, Georgia, and her practice Aarti D. Pandya, M.D., P.C. (“the Pandya Defendants”). The lawsuit alleges that the Pandya Defendants submitted false claims to Medicare for surgical procedures, diagnostic tests, and office visits that were medically unnecessary, of worthless value, upcoded, and in some cases, not provided at all.” Get the full scoop >>

3. Deeper Than the Headlines: OIG’s Medicare Compliance Review of Mobile Infirmary Medical Center – “The OIG’s most recent Medicare Compliance Review of a hospital was posted on their website on Oct. 24, 2018. The hospital that underwent the review was the Mobile Infirmary Medical Center. OIG found the hospital complied with Medicare billing requirements for 87 of the 100 inpatient claims they reviewed. However, the hospital did not fully comply with Medicare billing requirements for the remaining 13 claims according to the OIG. This resulted in net overpayments of $163,104 in calendar years 2015 and 2016.” Get the full scoop >>