Corporate Compliance

California medical billing company to pay $4.6 million in settlement to resolve false claims charges

Compliance Monitor, September 7, 2011

A provider of billing services for physicians, hospitals, and other healthcare providers will pay $4.6 million to settle allegations that it submitted false claims to Medicare and Louisiana’s Medicaid program, according to a September 1 press release by the Department of Justice.

Janzen, Johnston & Rockwell Emergency Medicine Management Services Inc. (JJ&R), of El Segundo, CA, allegedly inflated claims that it had coded on behalf of emergency room physicians in Louisiana and California.

From approximately 2000 through 2007, JJ&R used a coding formula that generated claims for a marginally higher level of evaluation and management (E&M) services than the physicians had actually provided. In addition, JJ&R routinely added charges to the E&M claim for minor services, such as pulse oximetry, that had been provided by hospital nursing staff or other physicians.

Read the full report on the Department of Justice website.


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