BECKLEY, WV (LOOTPRESS) – A Beckley-based medical clinic and its owner have agreed to pay more than $152,000 to resolve allegations that they improperly billed Medicare and Medicaid, according to the U.S. Attorney’s Office for the Southern District of West Virginia.
Med-Surg Physician Group Inc. and Dr. Oluyemisi Sangodeyi will pay $152,382.70 to settle civil allegations that they violated the False Claims Act by submitting false claims for reimbursement and falsely certifying compliance with federal program requirements.
According to investigators, Med-Surg improperly billed Medicare and Medicaid for a telehealth facility fee using procedure code Q3014, which is meant to cover the cost of connecting a patient at a medical facility to a remote provider.
Federal regulations prohibit billing this fee when a patient is at home.
“Dr. Sangodeyi and Med-Surg repeatedly billed for fees they knew they were not entitled to, at the expense of the American taxpayer,” said Acting U.S. Attorney Lisa G. Johnston.
A review of Med-Surg’s claims found that from March 25, 2020, to January 27, 2021, the clinic routinely billed for these fees, despite clear guidelines prohibiting such charges.
Investigators determined the clinic received $76,191.35 in improper payments during that period.
The investigation was led by the U.S. Department of Health and Human Services-Office of the Inspector General (HHS-OIG) and the West Virginia Attorney General’s Medicaid Fraud Control Unit.
“Accurately submitting claims for reimbursement from the Medicare and Medicaid Program is required of all health care providers,” said Maureen R. Dixon, Special Agent in Charge for HHS-OIG.
“HHS-OIG and the U.S. Attorney’s Office will continue to evaluate and pursue allegations of fraud in federal health care programs.”
West Virginia Attorney General JB McCuskey also reaffirmed the state’s commitment to protecting taxpayer dollars.
“We are committed to ensuring money for Medicare and Medicaid is used for its intended purpose,” McCuskey said. “Many people rely on these programs and we, with our partners, will continue to work to protect taxpayer dollars.”
The case was handled by the U.S. Attorney’s Health Care Fraud Task Force, which works with federal, state, and local agencies to investigate and prosecute health care fraud.
