An acupuncturist accused of falsely billing Medicare for his services has agreed to a $300,000 civil settlement agreement with the federal government.
According to the U.S. Attorney’s Office in Connecticut, Dr. Jun Xu, of Rehabilitation Medicine and Acupuncture Center M.D. LLC, which is located in the Riverside section of Greenwich, falsified bills to Medicare stemming from physical therapy services rendered at Xu’s practice.
Acting U.S. Attorney Deirdre M. Daly explained in a press release that Xu submitted claims to Medicare for physical therapy services that were medically unnecessary or not performed in accordance with Medicare requirements.
Specifically, the federal government alleges that Xu billed Medicare for one-on-one physical therapy services when the physical therapist was, in fact, providing group therapy, and that he submitted claims to Medicare for therapy services that were rendered by massage therapists. Medicare regulations explicitly state “the services of…massage therapists…may not be billed as therapy services,” according to Daly.
“Health care providers that overcharge Medicare drain critical funds from the Medicare program and increase health care costs,” Daly said in a statement. “The U.S. Attorney’s Office is committed to vigorously pursuing physicians and other health care providers who submit fraudulent claims to federal health care programs. Providers who submit false claims to the government face serious monetary and administrative sanctions.”
Under the False Claims Act, the government can recover up to three times its actual damages, plus penalties of $5,500 to $11,000 for each false claim. Federal officials said Xu’s falsified bills were submitted from the time period between Jan. 1, 2007 through Dec. 31, 2009.
To resolve their liability under the False Claims Act, Xu and his professional corporation entered into a civil settlement agreement for $300,000 with the federal government in order to reimburse the Medicare programs. Xu and his corporations did not admit any liability in settlement documents.
Xu’s lawyer, Jonathan J. Einhorn, of New Haven, characterized the entire situation as a “misunderstanding.”
“Dr. Xu, who is not a lawyer, had a hard time understanding specific billing procedures,” said Einhorn. “Having reviewed the regulations that confused him, I think it would confuse any of us. As far as we’re concerned, it was just a paperwork situation. He wasn’t prosecuted criminally and gave back a substantial amount of money because he really did misunderstand the regulations. Certainly he had no intent to defraud anybody.”
Xu is a licensed physician, certified acupuncturist and certified Chinese herbologist.
Rehabilitation Medicine and Acupuncture Center M.D., according to its website, claims to integrate the latest technologies of American medicine with the philosophies of traditional Chinese herbology and acupuncture to provide “natural, non-surgical, pain free and individualized patient care.” The practice treats everything from back pain to acne.
Einhorn described his client as a “competent doctor” who needed to hire a billing company to figure out state and federal billing regulations after it was clear he did not understand the rules himself. “And even they couldn’t figure it out,” said Einhorn.
An example of the complexity, Einhorn said the way that physical therapy gets billed differs under the state and federal laws, with federal law being more restrictive. Moving forward, Einhorn said his client has a better understanding of the billing regulations.
“It was an expensive education,” said Einhorn.
This case was investigated by the Office of Inspector General for the Department of Health and Human Services. The case was handled by Assistant U.S. Attorney Anne Thidemann, with the assistance of Auditor Kevin A. Saunders.•