Tri-State Specialists, L.L.P. (Tri-State), has agreed to pay $612,501.44 to the United States, the State of Iowa, and the State of South Dakota to resolve allegations that it violated the False Claims Act by billing Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program for medically unnecessary procedures and for procedures in excess of those actually performed.
The government alleged that, from August 2014 until August 2019, Tri-State submitted false claims for payment to government healthcare programs for surgical procedures and office visits performed by a plastic surgeon who previously was a partner with Tri-State. The government contended that claims submitted during this period violated the False Claims Act in three ways. First, the government alleged that the surgeon performed cosmetic procedures not reimbursable by government healthcare programs, including panniculectomies and abdominoplasties (also known as tummy tucks) and cosmetic breast reductions, that were falsely billed as medically necessary procedures. Second, the government alleged that the surgeon did not perform services sufficient to justify billing for high-value muscle flap and adjacent tissue transfer surgical procedures. Third, the government alleged that the surgeon did not perform services sufficient to bill for high-value office visits that require a comprehensive exam, comprehensive history, and detailed supporting documentation for patients that require moderately or...
The Kristo Asafo Mission of Ghana has rejected claims that former Dome-Kwabenya Member of Parliament, Sarah Adwoa Safo, was shot during an incident at the church’s property at Kwabenya, describing...