A pain clinic and a laboratory in Florida, both subsidiaries of Brentwood, Tenn.-based Surgery Partners, and two former Surgery Partners executives have agreed to pay $41 million to resolve alleged violations of the False Claims Act, according to the Department of Justice.
The settlement resolves allegations that Tampa (Fla.) Pain Relief Center and Logan Laboratories in Tampa billed Medicare and other government healthcare programs for medically unnecessary urine drug testing. Michael T. Doyle, former CEO of Surgery Partners, and Christopher Utz Toepke, former grou...
The Office of the Inspector General has released a report that raises questions about whether Medicare Advantage plans have inappropriately denied claims to increase profits.
Although it did not name specific plans, the OIG report is based on appeals to MA denials and the outcomes. MA organizations overturned 75 percent, amounting to 216,000 denials, from 2014 to 2016. Independent reviews at higher levels overturned an additional 80,000 denials during those two years in favor of the beneficiaries and providers, the report said.