FOR IMMEDIATE RELEASE                                         CIV
THURSDAY, JUNE 5, 1997                             (202) 616-2765
                                               TDD (202) 514-1888

                                 
    EMERGENCY PHYSICIAN GROUP TO PAY U.S. AND TEXAS $268,460
    FOR HEALTH CARE BILLING FRAUD INVOLVING FEDERAL AGENCIES
                                
     WASHINGTON, D.C. -- Coastal Emergency Physicians Group of
Texas, P.A., will pay the United States and Texas $268,460 to
settle allegations that Medicus Medical Group, which Coastal
acquired in January 1993, received over payments from federal
health insurance programs based on false claims submitted by
Medicus' billing company, the Department of Justice announced
today.  

     Assistant Attorney General Frank W. Hunger of the Civil
Division said Coastal, an emergency physician staffing company,
made the payment to resolve allegations of false billings by
Medicus to the Medicare, Medicaid and CHAMPUS programs. 
  
     The Department said Medicus hired an Oklahoma City billing
company, Emergency Physicians Billing Services (EPBS), to submit
claims on its behalf to federal and state health care programs. 
EPBS then submitted false Medicare, Medicaid and CHAMPUS claims
on Medicus' behalf for patients seen by Medicus physicians.  The
United States alleged that EPBS typically changed the codes of
claims submitted to the agencies and billed for services more
extensive than those actually provided by Medicus' physicians.  

     The agreement settles a dispute with Coastal originally
brought as a qui tam case in U.S. District Court in Oklahoma
City.  As part of the settlement, the estate of Theresa Semtner,
who filed the suit on behalf of the United States, will receive
approximately $47,394.  This is in addition to the $1.5 million
the estate will receive from a recent settlement with another
defendant in the action, EmCare Inc.  The United States is
continuing to pursue recoveries against EPBS and its other
customers.  

     The case, United States ex rel. Semtner v. Emergency
Physicians Billing Services, Civil Action No. Civ-94-617-(C)
(W.D. OK), was conducted by the Civil Division with the
assistance of the Department of Health and Human Service's
offices of Inspector General in Washington, D.C., and Dallas,
Texas; the Oklahoma City office of the FBI; the Tulsa Resident
Agency of the Defense Criminal Investigative Service; the Program
Integrity Branch of the Office of CHAMPUS; the Office of
Inspector General for the Office of Personnel Management in
Washington, D.C.; and various state attorneys general Medicaid
Fraud Control Units around the country.  Additional audit support
was provided by Xact, the Medicare intermediary in Pennsylvania. 
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