A Virginia ear, nose, and throat doctor and his medical practice have agreed to pay $625,000 to settle allegations of fraudulent billing practices involving government healthcare programs.
Dr. Scott Saffold and Chesapeake Bay ENT, P.C., in Virginia Beach, were accused of submitting false claims to government payors, including Medicare and Medicaid, for unnecessary and improperly billed procedures.
The U.S. Attorney’s Office for the Eastern District of Virginia and the Commonwealth of Virginia alleged that Dr. Saffold and his practice performed balloon sinus dilations on multiple sinuses without medical necessity.
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They also allegedly staged these procedures over separate occasions to maximize reimbursements. Furthermore, the complaint claimed they billed for complex endoscopic procedures involving the sphenoid sinus when these procedures were not actually performed.
This settlement stems from a lawsuit filed under the whistleblower provision of the False Claims Act, which allows individuals with knowledge of fraud against government programs to file lawsuits on behalf of the government. Whistleblowers are entitled to a portion of any funds recovered by the government.
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The resolution of this case involved collaboration between the U.S. Attorney’s Office, the Department of Health and Human Services Office of Inspector General, the Department of Defense Office of Inspector General’s Defense Criminal Investigative Service, and the Virginia Attorney General’s Office.
The $625,000 settlement resolves the allegations against Dr. Saffold and Chesapeake Bay ENT, P.C., without any admission of liability.
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