Corporate Compliance

Medical billing company pays $565,000 to settle healthcare fraud allegations

Compliance Monitor, January 12, 2011

MSO Washington, Inc., a medical practice management and billing service company, and Charles Plunkett, MSO’s owner, agreed to pay the United States $565,000 to settle allegations of healthcare fraud, according to a Department of Justice (DOJ) press release.

According to the DOJ, MSO allegedly submitted claims to Medicare and Medicaid (on behalf of MSO-contracted healthcare providers) for reimbursement for services that were:

  • Medically unnecessary
  • Lacking proper documentation
  • Billed at a higher level than were actually rendered (so-called “upcoding”)
  • Never actually rendered.

The MSO-contracted health care providers were generally unaware of MSO’s alleged inappropriate billing practices. MSO also entered into a five-year corporate integrity agreement with the OIG and will submit to annual audits by an independent audit firm. A former MSO employee filed the case under the qui tam provision of the False Claims Act.

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