A settlement has been reached to resolve False Claims Act allegations against Skyline Urology.
The allegations arose from a lawsuit that claimed Skyline Urology submitted improper claims to the Medicare program for evaluation and management services.
According to the government, between 2013 and 2016, Skyline Urology allegedly submitted false claims to Medicare for services that were not allowed under the Medicare program and improperly bundled services that would not have been separately billable.
“Physicians and practice groups are expected to bill Medicare properly for the services they provide,” said Assistant Attorney General Jody Hunt of the Department of Justice’s Civil Division. “This settlement sends a clear message that the Department of Justice will hold healthcare providers accountable if they knowingly overbill federal healthcare programs.”
“Providers are expected to closely follow Medicare rules and bill properly — nothing more, nothing less,” said Maureen R. Dixon, Special Agent in Charge of the Office of Inspector General of the U.S. Department of Health and Human Services. “Taxpayer money wasted is money stolen from this vital federal health program.”
Reportedly, Skyline Urology has also entered into an Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General that will require regular monitoring of its billing practices for three years.
The Whistleblowers, James M. Cesare, the founder of the consulting firm Bay Area Healthcare Advisors LLC, will receive approximately $323,750.