Medicare Advantage provider Seoul Medical Group and others are settling allegations of submitting false spinal diagnostic codes to increase payments, the U.S. Attorney’s Office said in a March 26 news release.
According to federal prosecutors, from 2015 to 2021, Min Young Cha, MD, and Seoul Medical Group submitted diagnoses for spinal enthesopathy and sacroiliitis, but the patients didn’t have the conditions. When questioned about its use of spinal enthesopathy, Seoul Medical Group had Renaissance Imaging Medical Associates create false radiology reports to support the diagnosis, according to the news release.
Seoul Medical Group and its subsidiary Advanced Medical Management, based in California, are paying $58.74 million. Dr. Cha agreed to pay $1.76 million to settle allegations of violating the False Claims Act for submitting the false diagnostic codes. Another group, Renaissance Imaging Medical Associates, is paying $2.35 million to settle allegations of conspiring with Seoul Medical Group in connection with the false diagnostics.
“We are pleased to have resolved this matter and demonstrated that SMG reversed the conduct described in the settlement,” a spokesperson for Seoul Medical said in an email to Becker’s. “The settlement will not have any financial, operational, or other costs or impact to SMG or AMM. We are committed to continually enhancing our practices and maintaining the highest standards of compliance. We remain focused on our mission of serving our communities and improving access, affordability and quality of healthcare for our patients.”