Florida physician network pays $1.7M for allegedly misusing billing codes

FWC Urogynecology, a network of urogynecologists throughout Florida, has agreed to pay the federal government $1.7 million to resolve allegations it violated the False Claims Act, according to the Department of Justice.

The government alleged FWC used billing codes with modifier 25, which can allow for additional payments from Medicare, for services that were not billable or that it did not provide. For example, FWC physicians performed and billed Medicare for lavage treatments and pelvic-floor therapies, then allegedly billed modifier 25 as if they provided another service, even though no additional medical care was provided.

A former FWC employee originally brought the allegations against FWC under the qui tam, or whistle-blower, provisions of the False Claims Act.

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