From: judgebean23x@gmail.com   
      
   The State | TheState.com   
      
   CRIME & COURTS   
   MAY 19, 2016 7:28 PM   
      
   EXCLUSIVE: Feds accuse big Midlands doctors group of fraud   
      
   Government accuses Family Medicine Centers of South Carolina of tacking on   
   extra unnecessary charges to patients’ bills   
      
      
   Allegation: For years Family Medicine Centers of South Carolina tacked on   
   extra unnecessary charges to patients’ bills   
      
   Doctors’ medical director, Dr. Stephen Serbin, denies all allegations   
      
   Government attorneys allege doctors ordered superfluous medical tests for   
   their own financial gain   
      
   BY JOHN MONK   
   jmonk@thestate.com   
       
       
       
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   COLUMBIA, SC    
   The U.S. Justice Department has filed a civil fraud suit against a major   
   Midlands family doctors group practice, alleging that for years the practice   
   illegally ramped up bills by adding unnecessary charges when patients came in   
   for visits.   
      
   Many of the alleged extra charges involved blood and liver tests to older   
   patients on Medicare, the lawsuit said.   
      
   Medicare, a federal elderly health care program, paid “over $9 million” in   
   improper payments to Family Medicine Centers of South Carolina, “many of   
   which were medically unnecessary,” according to a government lawsuit against   
   the practice.   
      
   Family Medicine Centers is one of South Carolina’s largest largest primary   
   care providers. It has six offices around the Columbia area, and its 18   
   physicians care for some 30,000 patients.   
      
   In bringing suit, the government joined an initial civil action against Family   
   Medicine Centers that was brought by a physician who once worked there.   
      
      
   In 2013, the practice fired that doctor, Catherine Schaefer, who then brought   
   her allegations about the practice’s billing procedures to the attention of   
   federal fraud attorneys in the U.S. Attorney’s office in Columbia.   
      
   Before joining her lawsuit, federal attorneys in Columbia, working with   
   counterparts in Washington, spent months investigating her allegations to see   
   how much, if any, fraud might be involved, U.S. Attorney Bill Nettles said   
   Thursday.   
      
   In a prepared statement released Thursday, Family Medicine Centers Medical   
   Director Dr. Stephen Serbin said, “This civil lawsuit was brought by a   
   disgruntled former employee who was terminated after spending less than nine   
   months at FMSC.   
      
   “Our practice firmly denies all of the allegations in this lawsuit, and will   
   vigorously defend it,” Serbin said. “FMSC has always placed the interests   
   of our patients above any self-interest, and maintains its commitment to the   
   families of South    
   Carolina.”   
      
      
   The practice’s motto is “Let Our Family Take Care of Your Family,” and   
   its philosophy can be summed up as “We pledge to be compassionate,   
   comprehensive, committed, competent, and cost-effective,” according to its   
   website.   
      
   But federal fraud attorneys allege Family Medicine Centers doctors   
   “routinely” broke their pledge to be cost-effective by ordering   
   “extensive and expensive laboratory tests for ... the physicians’ personal   
   financial gain, and not because such    
   tests were necessary.”   
      
   The case was brought under the federal false claims act, which provides for   
   triple damages and awards to be paid out by any party found guilty for   
   submitting fraudulent claims to the government. That means, if the government   
   can prove it was defrauded by    
   $9 million, a jury or judge could theoretically award damages up to $27   
   million.   
      
   In Schaefer’s lawsuit, which is a companion case to the government’s   
   lawsuit, she describes herself as a 1994 University of South Carolina medical   
   school graduate who had a family medical practice in Columbia with 3,000   
   patients before joining with    
   Family Medicine Centers in 2013.   
      
      
   In her solo practice, her lawsuit said, she worked extensively with Medicare   
   patients, as well as those with Tricare, a federal health care program that   
   covers active duty and retired military members and their familes, and was   
   familiar with the federal    
   laws concerning filing for reimbursements.   
      
   In April 2013, Schaefer closed her practice and went to work with Family   
   Medicine Centers at its Northeast Columbia location, “bringing with her the   
   3,000-patient practice she built over the previous 10 years,” according to   
   legal papers in the case.   
      
   Once at Family Medicine Centers, “a number of Dr. Schaefer’s patients   
   began complaining about inaccurate billing” such as being billed for a   
   nursing visit as well as getting a B-12 vitamin shot, whereas previously they   
   had only been billed for a B-   
   12 shot, her lawsuit said.   
      
   As time went by, and Schaefer repeatedly tried to correct her new group’s   
   billing system, she discovered “a concerted effort by defendants to   
   fraudulently increase healthcare services billed to patients and their   
   insurers, including federal programs,    
   in excess of fees actually earned or justified as medically necessary,”   
   according to her lawsuit.   
      
   The alleged improper jacking up of fees included a whole range of medical   
   services, including the double billing of patients, upcoding preventative   
   office visits as more costly “problem-related office visits,” urging   
   patients to undergo extensive lab    
   testing without determining if that testing was necessary and requiring   
   doctors to order more expensive lab tests for patients than were actually   
   warranted, according to Schaefer’s lawsuit.   
      
   During her seven months with Family Medicine Centers, Schaefer was warned   
   numerous times “for refusing to adopt” her new practice’s billing   
   system, her lawsuit said. Finally, after repeatedly refusing to “create   
   physician notes capable of    
   justifying fraudulent charges,” she was fired, her lawsuit said.   
      
   In his statement, Family Medicine Centers’ Serbin said his group “looks   
   forward to a time when we can address the allegations in this case publicly,   
   but due to the litigation process, we cannot do so now.”   
      
   In the 37 years it has been in existence, the group has “been dedicated to   
   improving the health of thousands of South Carolina families,” Serbin said.   
   “We are confident that we will continue in our leadership role within the   
   healthcare community.”   
      
   Nettles said the federal government’s system for reimbursing doctors depends   
   on doctors billing honestly.   
      
      
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