Oklahoma orthopedic practice pays for billing irregularities in $1.5M settlement: 7 things to know

Practice Management

Orthopedic and Sports Medicine Center-Norman (Okla.) found a billing problem in August 2016, according to The Norman Transcript.

Here are seven things to know:


1. The practice and its physician owners immediately contacted HHS' Office of Inspector General's Office of Investigations and Office of Audit Services to voluntarily disclose the discovered billing irregularities and documentation deficiencies.


2. Following the disclosure, the government investigated the billing problems.


3. Orthopedic and Sports Medicine Center's physicians Mark Moses, MD, David Bobb, MD, William Harris, MD, Vytautus Ringus, MD, Steven Schultz, MD, and Brad Vogel, MD, paid about $1.54 million to settle a civil claim suit.


4. The United States and State of Oklahoma alleged the practice submitted false claims to Medicare, Medicaid, the Department of Veterans Affairs and TRICARE.


5. Between Jan. 1, 2010, and Dec. 31, 2015, the practice did not bill the following correctly, according to The Norman Transcript:


• Physician extenders without documentation in progress notes to support billing, evaluation and management codes
• Durable medical equipment, prosthetics, orthotics and supplies issues
• Evaluation and management codes regarding hospital consults
• Physical therapy with documentation that didn't support CPT codes billed and/or the number of physical therapy units billed


6. Orthopedic and Sports Medicine Center cooperated during the investigation, providing access to privileged and non-privileged internal documentation, audit and medical records.


7. The practice did not claim liability in the settlement.


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