JACKSONVILLE, Fla. -- Bao Pham, D.O., and AccMed Healthcare Systems, LLC, also known as the Florida Spine Care and Pain Center have resolved allegations of violating the False Claims Act.
According to a United States Attorney's Office press release, the claims were submitted for medical services to the Medicare and Federal Office of Workers Compensation programs.
Bao Pham, D.O., and Florida Spine Care and Pain Center, have paid $448,794 to resolve the allegations, the release detailed.
The settlement involves allegedly submitting false claims between January 1, 2004, and December 31, 2008, for non-reimbursable procedures and services by up-coding and unbundling medical services provided to beneficiaries of these two federal programs.
Additionally, the government alleged that non-reimbursable procedure, performed in-office, as a surgical procedure and further routinely, unbundled claims for pain management services. This allowed forhigher reimbursement than if properly submitted.
"This settlement represents another notable achievement in our battle against health care fraud in this district," stated A. Lee Bentley, III, Acting United States Attorney for the Middle District of Florida. "Civil health care fraud enforcement is, and will continue to be, one of our top priorities."
"This settlement demonstrates the Office of Inspector General's commitment to investigate those who defraud the U.S. Department of Labor's Federal Employees' Compensation Program by billing for services that were not rendered. We will continue to work with our law enforcement partners to investigate these types of schemes," said Richard Walker, the Special Agent-in-Charge of the Atlanta Regional Office of the U.S. Department of Labor, Office of Inspector General, Office of Labor Racketeering and Fraud Investigations.
The release said the allegations arose from information received from a fraud investigator at a major health insurance carrier, which was simultaneously conducting an investigation into Dr. Pham's billing practices.
"Billing Medicare for one procedure but actually providing another, much cheaper procedure - as Pham allegedly did - is plain and simple fraud," said Christopher B. Dennis, Special Agent in Charge, Office of Inspector General, Department of Health and Human Services, Miami region. "When providers pad their pockets at Medicare's expense, they can expect the OIG to investigate and hold them responsible."
Pham is an osteopathic physician who focuses his practice on pain management and who, through Florida Spine Care and Pain Center, provides treatment to Medicare recipients for various conditions and to federal employees who are suffering various types of on-the-job injuries. Florida Spine Care and Pain Center is a Florida corporation located in Clay and Duval Counties in Florida.