Gastroenterology Group of Rochester Agreed to Pay $352,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting False Evaluation and Management Claims

Gastroenterology Group of Rochester Agreed to Pay $352,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting False Evaluation and Management Claims

After it self-disclosed conduct to OIG, Gastroenterology Group of Rochester, LLP (GGR), Rochester, New York, agreed to pay $352,442.46 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that GGR submitted claims to Federal health care programs for evaluation and management (E/M) services that had been furnished as split/shared visits between GGR physicians and hospital-employed advanced practice gastroenterology providers (APPs). These claims were improper because GGR physicians were not in the same group practice as the APPs and the billing provider did not perform the substantive portion of the visit.