ASHWAUBENON - Prevea Clinic has agreed to pay $94,000 to resolve allegations that it submitted false claims to the Medicare Program, the U.S. attorney's office said Tuesday.
The civil settlement resolves a lawsuit filed under the whistle-blower provisions of the False Claims Act.
The complaint alleges that Prevea submitted false claims to the Medicare Program for the services of an assistant surgeon during neurosurgery procedures between January 1, 2005 and November 20, 2010. The services of an assistant surgeon will be paid for by Medicare if the assistant surgeon has certain, specified credentials. It was alleged Prevea submitted claims for assistant surgeon services by an employee that did not have the credentials required by Medicare and submitted the claims for those services using another individual's provider number and credentials.
Prevea released a statement from its president and CEO, Dr. Ashok Rai Tuesday evening. It reads in part:
"Medicare payment rules are highly complex and we make every effort to correctly bill for our services. Although Prevea Health made no admission of liability in the Settlement Agreement, we have implemented additional review and audit processes to ensure accuracy and compliance with coding and billing rules.
Finally, it is important to note that at no time did this situation jeopardize patient care."
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