Howard County Physician Falsely Billed Externally-Applied Acupuncture Device, For Which Medicare Does not Reimburse, as a Surgical Implantation – Which Medicare Reimburses at $6,255 per Procedure
Baltimore, Maryland – Njideka Udochi, M.D., a family practice physician who owns Millennium Family Practice in Howard County, has agreed to pay the United States $663,094.76 to resolve allegations that she submitted false claims to the Medicare program for fraudulent neurostimulator billings, arising from the use of an auricular stimulation (“P-Stim”) device.
The settlement agreement was announced today by Acting United States Attorney for the District of Maryland Jonathan F. Lenzner and Maureen Dixon, Special Agent in Charge of the Office of Inspector General for the Department of Health and Human Services.
“Taping a device with adhesive is clearly not the same as surgical implantation,” said Acting United States Attorney Jonathan Lenzner. “Falsely billing the government for a procedure that reimburses at a high rate for such a simple procedure that is not reimbursed at all diverts valuable government resources and undermines confidence in our healthcare system. This settlement will restore funds that should not have been reimbursed and should serve as a bold reminder that improper billing will not be tolerated. I commend our partners at CMS’s Center for Program Integrity and HHS-OIG for identifying and eliminating this kind of waste and abuse in our federal healthcare programs.”
In her practice, Dr. Udochi used a P-Stim device to treat her pain patients. A P-Stim device provides electrical acupuncture to treat pain symptoms and is applied externally to the patient, generally behind the patient’s ear. Acupuncture, electrical or otherwise, is not reimbursable by Medicare.
According to the settlement agreement, from January 2019 to May 2019, Dr. Udochi falsely billed Medicare for the use of the P-Stim device by using the Healthcare Common Procedure Coding System (HCPCS) code for a neurosurgical procedure of an invasive and extensive nature where the device is implanted into the patient. HCPCS codes are used by Medicare to determine the level of reimbursement to providers. Medicare reimburses providers approximately $6,255.61 for an implantable neurostimulator procedure, reflecting the complexity and in-depth nature of surgical implantation of a neurostimulator. Despite the fact that Medicare does not provide any reimbursement for the use of acupuncture devices, Dr. Udochi’s false billing for P -Stim devices, that were taped behind the ears of her patients and were often removed by her patients at home without assistance from a medical professional, caused Medicare to pay her hundreds of thousands of dollars.
The claims resolved by this settlement are allegations. The settlement is not an admission of liability by Dr. Udochi, nor a concession by the United States that its claims are not well founded.
Acting United States Attorney Jonathan Lenzner commended the Office of Inspector General for the Department of Health and Human Services for its work in the investigation. Mr. Lenzner also thanked Assistant United States Attorneys Matt Haven and Allen Loucks, along with Investigators Steve Capobianco and Ann Thiel, who handled and investigated the case.
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