Another Upcoding Settlement

In February of 2014, Dr. Steven Chun agreed to pay $750,000 to resolve allegations that he and his clinic billed Medicare for physician office visits that he did not perform. In its pleadings, the United States alleged that Dr. Chun owned and operated a clinic called Sarasota Pain Associates with locations in Sarasota and Bradenton between 2006 and 2011. The United States alleged that, beginning in 2006, Dr. Chun billed Medicare for office visits at the highest levels possible, falsely claiming to have conducted comprehensive examinations of patients with complex problems. In fact, those patients visited Sarasota Pain Associates for scheduled procedures for which Dr. Chun was paid. The issue was that in addition to getting paid for those procedures, Dr. Chun billed and was paid by Medicare for examinations that he did not in fact perform.

The allegations covered by the settlement were raised in a lawsuit filed by two former nurses for Dr. Chun. In addition to the $750,000 payment, Dr. Chun will enter into a three-year Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General. The agreement requires Dr. Chun to attend training courses provided by the Centers for Medicare and Medicaid Services and to conduct an independent external review of his coding, billing, and claims submission to federal healthcare programs.

The lawsuit is captioned U.S. ex rel. Gavin v. Sarasota Pain Associates, P.A. and Steven Y. Chun, M.D., 6:11-cv-583-T-23TBM (M.D. Fla.).