LI surgeon reached settlement resolving fraud allegations
A Long Island orthopedic surgeon agreed Wednesday to pay the government $388,000 to resolve allegations that he falsely billed Medicare for spinal procedures conducted in 2005.
Richard S. Obedian "knowingly circumvented lower payment rates" for the procedures he performed by using "incorrect billing codes assigned to more complicated surgeries," the U.S. Department of Justice said in a news release announcing the civil settlement Wednesday. By using those incorrect codes, the government said, Obedian inflated his Medicare reimbursements.
The improper claims involved a procedure known as kyphoplasty, described by the Justice Department as "a minimally invasive procedure used to treat compression fractures of the spine" often attributed to or related to osteoporosis.
It was not immediately clear how many individual procedures were overbilled by Obedian. A government spokeswoman did not immediately respond to inquiries seeking additional information on the case.
The statement released by the Department of Justice said: "The claims resolved by this settlement are allegations only," adding that there is "no determination" of liability.
"We expect physicians who participate in federal health care programs to bill for their services accurately and honestly," the assistant attorney general for the Civil Division at the Department of Justice said in a statement, adding: "Neither the Department of Justice nor the taxpayers will tolerate those who knowingly overbill federal health care programs."
The settlement was the result of what the Department of Justice called "a coordinated effort" by its civil division and the U.S. attorney's office for the upstate Western District of New York and the Department of Health and the Human Services' office of the inspector general. It was part of a broader investigation into billing practices related to this specific spinal surgery procedure that the Department of Justice said has resulted in settlements with "more than 100 hospitals totaling approximately $75 million" for "mischarged" kyphoplasty.