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OrthoCarolina Agreed to Pay $316,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services that Exceeded the Allowable Number of Services

On April 2, 2024, OrthoCarolina, P.A. (OrthoCarolina), North Carolina, entered into a $316,568.02 settlement agreement with OIG. The settlement agreement resolves allegations that OrthoCarolina submitted claims to Medicare for epidural steroid injections that exceeded the allowed number of: (1) transforaminal injections per session; (2) total number of blocks per sessions; (3) spinal regions per session; or (4) epidural steroid injections in 6 or 12-month periods. OIG's Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsel Gregory Becker with the assistance of Program Analyst Mariel Filtz, collaborated to achieve this resolution.

Action Details

  • Date:April 2, 2024
  • Enforcement Types:
    • CMP and Affirmative Exclusions