A significant Medicare fraud settlement has been reached in Chattanooga, Tennessee, where Apple Corporate Wellness, Inc. (now operating as Bryn Medical Center and Basket Medical PLLC) has agreed to pay over $1.1 million to resolve allegations of improper billing practices.
Details of the Fraudulent Billing Scheme
The case centers around the improper billing of electro-acupuncture devices between June 2016 and June 2017. The provider allegedly submitted false claims to Medicare using HCPCS Code L8679, a code specifically designated for surgically implanted neurostimulator devices. The investigation revealed that the provider was merely inserting needles into patients' ears and taping devices behind patients' ears with adhesive, while billing these simple procedures as complex surgical implants.
Medicare Billing Violations
The fraudulent activity was particularly concerning because the procedures did not involve surgical implantation, no anesthesia was used, and the procedures were not performed in an operating room. Furthermore, Medicare did not cover acupuncture during the period in question.
The Settlement Agreement
The resolution resulted in a payment of $1,148,598 to settle the False Claims Act violations. This settlement was achieved through the coordinated efforts of the U.S. Attorney's Office for the Eastern District of Tennessee, the Office of Inspector General of the U.S. Department of Health and Human Services, and the Southeastern Unified Program Integrity Contractor.
Understanding Medicare Fraud and Whistleblower Impact
Medicare fraud continues to be a significant concern in the healthcare industry, costing taxpayers billions of dollars annually. Whistleblowers play a crucial role in identifying and stopping fraudulent practices, protecting both patient care quality and public funds. Their courage in coming forward helps maintain the integrity of healthcare programs and ensures that medical providers remain accountable for their billing practices.
Take Action Against Medicare Fraud
If you have knowledge of similar Medicare fraud schemes or other healthcare billing violations, The Whistleblower Advocates in Philadelphia are here to help. Our experienced attorneys offer free, confidential consultations to discuss your case and protect your rights. Contact us today to speak with a qualified whistleblower attorney who can guide you through the process of reporting fraud while protecting your interests and potential rewards under the False Claims Act.
This article is a news article for informational purposes only. The Whistleblower Advocates did not represent the parties identified in the story above.
