Five healthcare providers in Maryland have agreed to settle U.S. government claims stating that they submitted false Medicare bills for duplex Doppler ultrasound studies.
The settlement agreements and the amounts each provider paid were as follows:
- Saint Agnes Healthcare (owner and operator of Saint Agnes Hospital in Baltimore): $69,906.90
- Horizon Vascular Specialists (a medical practice with offices in Frederick, Germantown, Olney, and Rockville): $518,479.50
- Riverside Medical Assoc. (a medical practice in Riverdale): $176,511.17
- Maryland Specialty Group (a medical practice in Glenn Dale): $87,393.89
- Dr. Itsuro Uchino (a physician in Hagerstown): $91,476.02
Each of these providers had performed venous duplex Doppler ultrasound studies to determine if there were blood-flow issues including deep vein thrombosis in patients' legs, and each had submitted a bill to Medicare under current procedural terminology (CPT) code 93970. They also, however, each billed for an additional test using CPT code 93965 -- a code that references an older, different technology that has been replaced by the technology covered by CPT code 93970, according to the U.S. Attorney's Office for the District of Maryland.
After being contacted by the U.S. attorney's office and the U.S. Department of Health and Human Services (HHS) Office of Inspector General, all agreed that the billing of CPT 93965 was incorrect and agreed to settlements. The U.S. attorney's office noted, though, that all five providers denied the false-claims allegations and there has been no determination of liability.
