Physician Agrees to Settle False Claims to Medicare for Services to Nursing Home Residents
Baltimore, Maryland - William Crittenden, M.D., of Kensington, Maryland, has agreed to pay the United States $225,000 to settle claims that he submitted false claims to federal health benefits programs over a twenty month period between January 1, 2003 and November 30, 2005.
The settlement was announced by United States Attorney for the District of Maryland Rod J. Rosenstein and Special Agent in Charge Nicholas DiGiulio, Office of Inspector General of the Department of Health and Human Services, Philadelphia Region which includes Maryland.
According to the settlement agreement, from January 1, 2003 to November 30, 2005, Dr. Crittenden submitted fraudulent claims to the Medicare program in connection with his visits to residents in nursing homes. Dr. Crittenden had a doctor-patient relationship with the Medicare beneficiaries in nursing homes or other assisted living facilities in Maryland. For each of these Medicare beneficiaries, Dr. Crittenden established a treatment plan that involved seeing each patient monthly. The billing codes that Dr. Crittenden used for these appointments were time sensitive and were intended to reflect the amount of time that the physician spent with the patient. The codes that Dr. Crittenden used reflected the expenditure of more time than he devoted, on some days indicating that the amount of time exceeded the ordinary work day, and on more than one occasion, exceeded 24 hours.
Dr. Crittenden denies the allegations.
Enacted during the Civil War, the False Claims Act is the government’s primary civil tool to combat fraud and abuse in federal programs and procurement. The Act allows the government to recover triple the amount of its actual damages, plus a civil penalty of $5,500 to $11,000 for each false claim and permits the payment of a portion of any settlement or judgment under the Act to individuals who bring fraud to the attention of authorities.
United States Attorney Rod J. Rosenstein commended Assistant U.S. Attorney Allen F. Loucks, who handled the case.