Hospitalist group settles billing fraud case for $4.2M

Fredericksburg (Va.) Hospitalist Group and 14 of its member physicians have agreed to pay $4.2 million to resolve False Claims Act allegations, according to the Department of Justice.

The government alleged FHG and the 14 hospitalists increased the level of evaluation and management codes to the highest code level to receive increased reimbursement from Medicare and other government payers.

FHG and the physicians allegedly illegally upcoded claims for services provided to patients at Mary Washington Hospital in Fredericksburg and Stafford (Va.) Hospital from January 2010 through April 2015, according to the DOJ.

The allegations against FHG were originally brought under the qui tam, or whistle-blower, provisions of the False Claims Act.

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