Kenneth Wiseman, DO, and Steven Schmidt, DO, owners of Philadelphia-based Complete Physician Services, have agreed to pay $1.5 million to settle false claim violation allegations, the Justice Department reported May 24.
The two physicians were accused of submitting false claims by misrepresenting the severity of illness and services rendered to increase reimbursement from the Medicare Advantage and Part B programs.
Between January 2015 and December 2018, CPS allegedly submitted unsupported diagnosis codes, resulting in higher reimbursement to Medicare Advantage health insurance companies, including submitting morbid obesity diagnosis codes in cases where patients had a body mass index under 35.
During this time, CPS also allegedly submitted unsupported claims to Medicare Part B, inappropriately billed physician assistant services, submitted unsupported billing to CMS for smoking cessation counseling and pulmonary function tests, as well as unsupported claims for vaccine administration.