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Greater Metropolitan Orthopedics Institute Pays $2.5M to Settle Upcoding Allegations

January 12, 2011

According to DoJ, Maryland-based Greater Metropolitan Orthopaedics Institute will pay $2.5 million to avoid litigating claims that it “upcoding services rendered to higher levels to increase its reimbursement.”  The resolved suit was filed under the federal False Claims Act and alleged that the group submitted fraudulent claims for “office visits that either never took place or were not documented in the patients’ medical records.  Additionally, the suit alleges that Greater Metropolitan Orthopaedics Institute billed Medicare, and the Federal Employees Health Benefits Program for “existing patient visits as consults, and submitt[ed] duplicate claims for review and interpretation of X-rays.”

To report healthcare fraud, contact Frohsin & Barger.

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