The settlement resolves allegations that Jose Escandon, MD, caused claims to be submitted to Medicare for ultrasounds that were medically unnecessary. The claims were allegedly submitted from Aug. 1, 2014, to Oct. 31, 2018.
A federal investigation was launched after a review of claims data showed Dr. Escandon was a statistical outlier for ultrasound claims.
As part of the settlement, Dr. Escandon entered into a three-year integrity agreement with HHS’ Office of Inspector General. The agreement requires the physician and his clinic to establish and maintain a compliance program and hire an independent organization to do a quarterly claims review, according to the Justice Department.
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