Mass. Physician Settles on Civil Suit; Charged with Overbilling Medicare for Claims

A Newton, Massachusetts doctor has paid $447,145 to resolve claims by the government that he overbilled Medicare.

United States Attorney Michael Sullivan and Joseph Moraski, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations, announced that the United States has settled civil claims against John T. LaRossa, M.D., under the False Claims Act. Dr. LaRossa paid $447,145 to resolve the claims.

Based on its investigation, the United States alleged that Dr. Larossa had overbilled Medicare during the period Jan. 1, 1998 to Dec. 31, 2003, by charging for “consultation” services that provided higher reimbursement, when he was actually performing regular patient visits; by improperly coding certain routine blood draws; and by submitting claims for direct measurement cholesterol tests that were actually calculated test results.

By means of the settlement, the government has recovered all of the overpayments, plus additional sums to offset the government’s cost of investigating this matter.

Also, by the terms of the Settlement Agreement, Dr. Larossa has entered into an Integrity Agreement with the Department of Health and Human Services, Office of Inspector General in order that, among other things, his compliance with the Medicare billing guidelines can be monitored.