Thursday, April 7, 2016

Napa Gastroenterologist Agrees To Pay $400,000 To Settle Allegations That He Upcoded Patient Visits and Unbundled Conoloscopy Charges To The Medicare Program

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.


DISCLAIMER: Green & Associates' articles and blog postings are prepared as a service to the public and are not intended to grant rights or impose obligations. Nothing in this website should be construed as legal advice. Green & Associates' articles and blog postings may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents and contact their attorney for legal advice. The primary purpose of this website is not the commercial advertisement or promotion of a commercial product or service and this website is not an advertisement or solicitation. Anyone viewing this web site in a state where the web site fails to comply with all laws and ethical rules of that state, should disregard this web site.

The information provided on this website is for informational purposes only. It is not intended to create, and does not create, a lawyer-client relationship with Green & Associates, Attorneys at Law. Sending an e-mail to Tracy Green does not contractually obligate them to represent you as your lawyer, or create any type of client relationship. No attorney-client relationship will be formed absent a written engagement or retainer letter agreement signed by both Green & Associates and client and which specifies the scope of the engagement.

Please note that e-mail transmission is not secure unless it is encrypted. E-mail messages sent to Ms. Green should not include confidential or sensitive information.