KNOXVILLE, Tenn.- A settlement was finalized this week with Apex Medical Group, P.C., d.b.a. Nephrology Consultants, a local nephrology physician practice group, and certain affiliated dialysis centers in Knox and surrounding counties. Apex Medical Group (Apex) agreed to pay $4.36 million to settle alleged violations of the federal False Claims Act, the Tennessee Medicaid False Claims Act, and other federal and state laws and regulations.
A government investigation revealed that from at least 2001 through 2006 Apex submitted numerous false and fraudulent claims to government health programs, including Medicare and TennCare, for payment through a pattern of upcoding for various physician services. During that same time frame, the six dialysis clinics owned by Extracorporeal Technologies, Inc., and Fort Sanders Kidney Center, Inc., improperly submitted inaccurate claims to these government health programs for a variety of dialysis services.
"The federal False Claims Act is intended to provide a means for the government to recover moneys paid by federal programs to persons and companies who have knowingly sought and received funds to which they were not entitled." explained U.S. Attorney Bill Killian. The payment Apex must now make in connection with this settlement is to compensate both federal and state government health programs, for funds it received as a result of improper billing practices. "Public funds pay for the largest share of healthcare services provided in the United States and we must ensure that such funds are paid only when authorized by law,” said U.S. Attorney Killian.
As part of this overall settlement, Apex and Dr. Naseemul Siddiqi have entered into a comprehensive five-year Integrity Agreement with the Office of Inspector General of the U. S. Department of Health and Human Services to ensure the future compliance of the Apex with federal health care benefit program requirements.
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