Pathologist Agrees to Pay over $457,000 and Enter into an Integrity Agreement to Settle Claims of Improper Billing
Baltimore, Maryland - Shahla Moshiri, M.D., a pathologist who owns and operates Chesapeake Diagnostics Laboratory, Incorporated (“CDL”), a cytopathology testing facility located in Cockeysville, Maryland, has agreed to pay the government $457,379.07 to settle claims under the False Claims Act that she, through CDL, billed Medicare and the Federal Employees Health Benefits Program (“FEHBP”) for medically unnecessary services and services not rendered, announced Rod J. Rosenstein, the United States Attorney for the District of Maryland.
“The resolution of this matter underscores our commitment to ensure that the critical resources of federal health care programs are not improperly diverted to reimburse claims that should not be paid,” said United States Attorney Rod J. Rosenstein. “The settlement provides for the recovery of monetary damages and the protection of health care programs that taxpayers depend upon through the use of a monitored integrity agreement that promotes compliance with federal health care program regulations, ” he added.
According to the settlement agreement, between January 2002 and July 2005, Dr. Moshiri, through CDL, billed both Medicare and the FEHBP for the physician interpretation of Pap smears that were not abnormal and therefore did not warrant such interpretation. Additionally, during that same time period, Dr. Moshiri billed both of the health care programs for consultation and for the preparation of medical reports without documentation supporting the claims for reimbursement.
Dr. Moshiri has agreed to abide by the terms of an Integrity Agreement for five years, which requires her and any entity in which she has a controlling interest, including CDL, to have, among other things, written procedures related to billing and medical record documentation, an employee training program, and review of claims submitted to federal health care programs. The settlement agreement is neither an admission of liability by Dr. Moshiri nor a concession by the United States that its claims are not well founded.
United States Attorney Rod J. Rosenstein commended the Offices of the Inspector General for the Department of Health and Human Services and the Office of Personnel Management for their investigative work in this case. Mr. Rosenstein thanked Assistant U.S. Attorneys Tarra DeShields and Jamie Bennett, who handled the case.