Pediatricians to Pay $540,000 in Billing Settlement

Wednesday, December 18, 2013, Vol. 128, No. 246

MEMPHIS (AP) – A Memphis pediatric group has agreed to pay the state more than $540,000 to settle allegations that the group was overcharging on TennCare billings.

According to a news release from the attorney general's office, the state alleged that Segal, Parker, Kronenberg, Tsiu and Eiseman, and three of its affiliated pediatricians billed for doctor's visits using the wrong codes. That allowed them to be paid more than what they were entitled to.

The Tennessee Medicaid False Claims Act allows the state to recover penalties and triple damages against health care providers who bill TennCare with reckless disregard as to the truth of their billings.

The practice group was identified by TennCare's Office of Program Integrity during normal data analysis.

There was no evidence of any patient harm in the case.

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