Dr. Steven Spillers settles allegations that he overbilled Medicare by paying over $740,000
DENVER – Dr. Steven Spillers has paid the United States $747,013.20 to settle allegations that he overbilled Medicare by billing, on numerous days, for more hours than he actually worked in that day. Separately, Dr. Spillers has also entered into an agreement with the Department of Health and Human Services, Office of Inspector General, that his Medicare billings will be monitored for the next five years.
Dr. Spillers provides a medical service called intraoperative neuromonitoring. A medical provider engaged in intraoperative neuromonitoring, or IOM, uses electrical methods to monitor a patient’s nervous system during a surgery. When IOM is performed from a location other than the operating room where the patient is having surgery, it is known as “remote IOM.” Remote IOM can be conducted from any location, because the provider can monitor the surgery by watching a screen. Remote IOM also potentially permits providers to monitor more than one patient at a time. However, the Medicare program only reimburses IOM providers for each minute of their time once. Thus, if an IOM provider monitors 3 patients during the same hour, that provider cannot bill Medicare for 3 hours, but rather can only bill Medicare for the 1 hour the provider actually worked.
Here, the United States alleged that Dr. Spillers submitted claims to the Medicare program to be paid for IOM services in excess of the number of hours that he actually worked, and in violation of Medicare’s rules. In fact, the United States alleged that on more than one hundred days, Dr. Spillers billed Medicare for more than 24 hours of IOM services.
Dr. Spillers has paid the United States $747,013.20, for the time period of March 3, 2008, to November 30, 2010, to resolve these allegations. He has also entered into an Integrity Agreement with the Department of Health and Human Services, where he will have his Medicare billings monitored for the next five years. These agreements are neither an admission of facts or liability by Dr. Spillers, nor a concession by the United States that its claims are not well-founded.
“Dr. Spillers’ job was to conduct remote electronic monitoring of patients’ nervous systems during surgery,” said U.S. Attorney John Walsh. “But Dr. Spillers billed Medicare for monitoring multiple patients at one time – in essence, billing each minute of his time double or triple, contrary to the clear rules. Medical providers should not overbill taxpayers, and when they do, they will pay the price.”
“The submission of false claims jeopardizes the public’s access to the Medicare program. The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) and the District of Colorado, United States Attorney’s Office will continue to vigilantly protect the Medicare trust fund through their various means of enforcement to include the Federal False Claims Act,” said Gerry Roy, Special Agent in Charge, HHS OIG.
This matter was handled by the Department of Health and Human Services, Office of the Inspector General. Assistant U.S. Attorney Marcy Cook handled this case for the U.S. Attorney’s Office.