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May 27, 2022

Failure to Provide Required Supervision May Be Considered Fraud

 On May 17, DOJ announced a settlement of nearly $300,000 to resolve False Claims Act allegations related to a medical facility’s claims for radiation therapy and diagnostic services that were provided without the requisite direct supervision. While the services were actually furnished to patients, the supervising physician was not immediately available to provide the direction and assistance required for coverage of such services. This case highlights the importance of meeting all supervision requirements before submitting a claim for reimbursement as the failure to meet such requirements could be considered fraud. This matter was brought to the attention of the government by a former employee of the medical facility as a qui tam action.  

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