03-17-05 -- UMDNJ and University Physician Associates -- Settlement -- News Release

UMDNJ and University Physician Associates Agree to Pay $1.4 Million for Medicare Overbilling

NEWARK - The University of Medicine and Dentistry of New Jersey and University Physician Associates of New Jersey, Inc. has agreed to pay a total of $1,407,448 to settle claims that they overcharged Medicare, U.S. Attorney Christopher J.Christie announced.

A settlement agreement signed Wednesday provides that UMDNJ and University Physician Associates of New Jersey will pay the government a combined total of $1,407,448 to settle claims that from July 1, 1995 through June 30, 1996 they wrongfully submitted claims for services to Medicare patients that they represented were personally provided by teaching faculty physicians employed by UMDNJ or University Physician Associates. The government alleged that UMDNJ and University Physician Associates did not possess required documentary evidence to support those Medicare claims, according to Assistant U.S. Attorney Stuart A. Minkowitz.

The settlement is the result of the U.S. Department of Health and Human Services' nationwide initiative to review compliance with the rules governing the Medicare Part B payment for physicians at teaching hospitals, known as the "PATH" initiative.

The settlement comes under the federal False Claims Act that permits the government to seek up to triple damages plus penalties for false or fraudulent claims to the government.

While agreeing to the settlement, UMDNJ and University Physician Associates, a so-called faculty practice plan at UMDNJ, have denied the government's allegations, according to Minkowitz. UMDNJ and University Physician Associates cooperated during the government's investigation.

Christie credited the Office of Audit Services, Office of Inspector General, U.S. Department of Health and Human Services with developing the case.

The government is represented by Assistant U.S. Attorney Minkowitz, the Civil Health Care Fraud Coordinator in the Affirmative Civil Enforcement Unit of the U.S. Attorney's Civil Division in Newark, and Gregory J. Wellins, Senior Counsel, Office of Counsel to the Inspector General, U.S. Department of Health and Human Services.

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Defense Counsel:

Hervé Gouraige, Esq., Newark (UMDNJ)

David M. Hyman, Esq., West Orange (University Physician Associates)