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.
SMP Resource Center products often contain links to copyrighted material. The SMP Resource Center is providing these links as a convenience and for informational purposes in our efforts to report and educate on Medicare fraud; they do not constitute a guarantee, endorsement, or approval by SMP of any of the information available on the external site. SMP bears no responsibility for the accuracy, legality, or content of the external site or for that of subsequent links. If you have any questions or concerns about the links provided, please contact the SMP Center at nliebau@smpresource.org.