Urgent Care Doctor and his Facilities Settle Allegations of Federal Health Care Fraud
Josef Schenker and Urgent Care Centers Resolve Claims for Billing Medicare for Purported Treatment Not Provided When Administering COVID-19 Vaccines and Tests
(STL.News) Breon Peace, United States Attorney for the Eastern District of New York, announced today that Dr. Josef Schenker and two urgent care facilities owned by him, Josef Schenker, M.D., P.C., and Care Partners Medical Management, LLC, have agreed to pay $564,217.70 to resolve allegations that they submitted false claims to Medicare for services not provided in administering COVID-19 vaccines and tests.
“In billing for medical services that were not provided to patients receiving COVID-19 vaccines and tests, Dr. Schenker exploited the pandemic for his own personal benefit,” stated United States Attorney Breon Peace. “This Office is committed to combatting fraud and abuse of our taxpayer-funded programs.”
This resolution follows the Department’s recent announcement of a nationwide coordinated law enforcement action to combat health care- related Covid-19 fraud.
When health care providers bill Medicare for COVID-19 tests and vaccines, they use certain Current Procedural Terminology (CPT) codes that specify the services that have been provided. In doing so, they signify that the services were performed as described and properly billed in accordance with industry standards. Applicable industry standards preclude physicians from billing for mid-level or high-level evaluation and management office visits when a Medicare beneficiary actually receives only a COVID-19 vaccine or test.
An investigation by the United States Attorney’s Office for the Eastern District of New York revealed that, from July 2020 to December 2021, Dr. Schenker routinely used CPT codes which falsely indicated to Medicare that he had conducted detailed examinations of the patients during mid-level and high-level evaluation and management office visits when, in fact, he had provided only a COVID-19 vaccine or test. The settlement resolves potential claims that Dr. Schenker’s alleged conduct violated the False Claims Act, 31 U.S.C. §§ 3729-33. The claims resolved by the settlement are allegations only.
The United States’ case was handled by Assistant U.S. Attorney Ekta Dharia of the Office’s Civil Division with assistance from Civil Investigator Joseph Giambalvo.