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Justice News

Department of Justice
U.S. Attorney’s Office
District of Maryland

FOR IMMEDIATE RELEASE
Friday, March 16, 2018

United States Reaches Settlement With Maryland Healthcare Providers To Settle False Claims Act Allegations Relating To In Office Testing

                                                                               

FOR IMMEDIATE RELEASE                                                       Contact ELIZABETH MORSE

www.justice.gov/usao/md                                                                 at (410) 209-4885

Baltimore, Maryland – The United States Attorney’s Office announced today that it has in recent weeks reached settlements with four health care providers to settle claims that they submitted false claims to the United States for services not rendered. 

St. Agnes Healthcare, Inc., which owns and operates St Agnes hospital in Baltimore, has agreed to pay $69,906.90.  Horizon Vascular Specialists, a medical practice with offices in Frederick, Germantown, Olney and Rockville, has agreed to pay $518,479.50. Riverside Medical Associates, a medical practice located in Riverdale, Maryland, has agreed to pay $176,511.17. Maryland Specialty Group, a medical practice in Glenn Dale, Maryland, has agreed to pay $87,393.89. Itsuro Uchino, M.D., a physician in Hagerstown, has agreed to pay $91,476.02. 

The settlement agreements were announced by Acting United States Attorney for the District of Maryland Stephen M. Schenning and Maureen Dixon, Special Agent in Charge of the Office of Inspector General for the Department of Health and Human Services.

In their practices, each of these providers had occasion to administer tests to patients to assess the venous sufficiency in the lower extremities. As part of this process, they performed a venous Doppler duplex examination. The purpose of this examination was to determine if there were blood flow issues including deep vein thromboses in the patient’s legs. They billed Medicare under CPT 93970 for this work.

Billing records showed that each billed for an additional test using CPT 93965. CPT 93965 references an older, different technology, one that has generally been replaced by the CPT 93970 technology. Upon inquiry by the U.S. Attorney’s Office and the HHS Office of Inspector General, each agreed that the billing of CPT 93965 was incorrect.

The claims resolved by this settlement are allegations only, and there has been no determination of liability. Maryland Specialty Group, St Agnes Healthcare, Riverside Medical Associates, Dr. Uchino, and Horizon Vascular Specialists have denied the allegations. 

Acting U.S. Attorney Stephen M. Schenning thanked Assistant United States Attorney Allen Loucks and Investigator Steven Capobianco who handled these cases.

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Updated March 16, 2018