On or about April 1, 2016 Dr. Ali S. Vaziri, a gastroenterologist in private practice in Napa, California, agreed (without admitting any liability) to pay the United States $400,000 to settle allegations that he submitted false claims for reimbursement to the Medicare program in violation of the False Claims Act.
The U.S. Department of Health and Human Services and Office of Inspector General ("government") alleged that from 2007 to 2011, Dr. Vaziri allegedly billed Medicare for patient office visits that reflected more time and services than he actually spent with patients. In addition, the governmet alleged that Dr. Vaziri allegedly billed Medicare for patient office visits that were required to be billed together with routine colonoscopies as one charge. Dr. Vaziri did not admit liability but entered into a settlement agreement in order to resolve the matter.
Settlements in these cases often make sense where the legal fees in challenging or litigating a false claims act case could easily exceed the amount of the settlement. It also helps guarantee that no criminal charges for Medicare fraud will be filed. In addition, for providers who see a significant amount of Medicare patients, it may be important to resolve administrative disputes with Medicare and to demonstrate an effective compliance plan is in place.
Posted by Tracy Green, Esq.