PORTLAND, Maine — A Maine doctor has agreed to pay the federal government more than $300,000 to settle claims that he improperly billed federal health care programs.
Dr. Peter M. File, an osteopathic physician with offices in Freeport and Alexandria, Va., agreed to pay $321,443, according to U.S. Attorney Thomas E. Delahanty II.
The United States filed a civil complaint on Sept. 28, 2012 alleging that File violated the federal False Claims Act between October 2005 and June 2011 by billing Medicare and TRICARE for providing osteopathic manipulative treatment, evaluation and management services to patients in violation of applicable Medicare billing guidelines, according to a press release from the U.S. Attorney’s Office.
Medicare provides health insurance primarily to disabled and elderly Americans. TRICARE provides civilian health benefits to military personnel, military retirees and their dependents.
The federal prosecutor alleged that File submitted $315,943 in false claims to Medicare and TRICARE. The complaint sought damages equaling the full amount of the false claims, along with $5,500 in statutory penalties, for a total of $321,443. File cooperated in the investigation, according to the press release.
File’s lawyers said in a statement that the complaint was the result of “complex federal regulations” and had nothing to do with patient care or safety, according to the Associated Press. File admits no liability and settled the case to avoid a lengthy and costly legal process, the lawyers said.
So he got caught and paid his way out?
or was this a paperwork snafu and had no criminal intent?
Haha
That’s exactly what it was. He treated patients, they were helped by his treatment, the government said they weren’t going to cover the work he did, because of this clause on page 197 here in paragraph 8 – you know, the one nobody here knows anything about, but has an opinion on…
Now if we could only get Nutting to pay back the money he stole as well!!!
If this is an issue to you then you have a moral responsibility to pursue it. It is irresponsible of you to just complain. If he is a thief then YOU need to follow up.
It is settled already–I think you probably knew this. We will not get the money back from Mr. Nutting.
Nutting declared bankruptcy and the debt was discharged. He then became speaker of the house.
Those job creators…ya have to watch ’em every minute.
Ha! We could save a lot of time watching if we could simply check all of their Swiss and Cayman bank accounts. I hear they create a lot of banking jobs in those countries.
is everyone still going to blame the “freeloading patients”? I wonder if anyone has tallied up how much this kind of thing adds up to when they “blame the victim (patients)” and the need to “revamp the system”
He should of done what everyone else does.. Treat one problem at a time. keep having the patient coming back 2- 3 times a week. Thats how they make the money.
He is an osteopath, not a chiropractor. Not saying chiropractors are bill happy, that is how chiropractics work.
Having been made a believer after being attacked by a patient I was x-raying, I had a dislocation of one of the small joints in my neck. After 6mos of orthopedic treatment and plans for surgery, a chiropractor that I knew offered to treat me for free if he could not help me and to bill Comp and accept their payment level if he could. He had me come to the office DAILY, Saturday and Sunday included. He was able to reduce the dislocation and I motion in my neck for the first time in more than 6 months after just a week. I was a clear non-believer before this, but now I would not consider surgery or any other route without first trying chiropratics first.
I don’t know if you have ever read a Federal rule release, but they are rarely less than seventy pages of what will and won’t be covered. What I don’t understand, if the services were not covered services, how did they pay the claim?
I think that’s the point though; why go after a large corporation with hoards of lawyers on retainer with poor patient satisfaction when you can go after the little guy that’s actually making a difference that nobody’s complaining about ? It makes it look like you’re doing your job, even if it screws future patients out of effective treatment options.
It’s not like it was a couple of thousand. This is a lot of charges.
The providers who defraud the system do it on a much larger scale than the individual. I think that it is only right that the powers that be go after them at least as aggressively as they do after the average person who rips off the system. It is not need, but greed that drives them.
It’s difficult for doctors that do not rely exclusively on surgery and pharmaceuticals to get compensated for their work, because the system is so cumbersome and complex, and favors cutting and drugging over treatment options that focus on the body’s ability to heal itself, given the correct encouragement.
This isn’t some grand example of fraud or malpractice; the lawyers and the physicians and their office staff are the ones that struggle with the mess of regulations that have been put in place by the politicians bought off by the insurance industry and other medical monopoly special interest groups. The end result is a system that is exceedingly complex, arguably subjective, and designed to restrict patient treatment options and choices.
D. File’s patients didn’t initiate this suit. Someone gunning for osteopathy did.
no such thing as a poor doctor … or a poor lawyer for that matter
Compared to most of the rest of the world, there’s no such thing as a poor American.
The article does not explain what the conflict is.
It has to be possible for some people to have coverage under both Plans.
I would think the veteran patients would know more about what services fall under which Plan ie
is the treatment related to miltary service injury or a repetitive injury from a civilian labor job, or both, for instance?
I could imagine one might be considered Primary and the other Secondary. Not unheard of.