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Northwell Healthcare Agreed to Pay $411,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services Not Performed, that Did Not Meet Coverage Criteria, or Were Upcoded

After it self-disclosed conduct to OIG, Northwell Healthcare, Inc. (Northwell), New Hyde Park, New York, agreed to pay $411,184.70 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Northwell submitted office-based evaluation and management claims on behalf of a physician for services which were not performed or otherwise did not meet coverage criteria. OIG also alleged that Northwell submitted claims for evaluation and management services on behalf of the physician for which the physician improperly overstated the amount of time spent with patients to increase reimbursement.

Action Details

  • Date:June 4, 2025
  • Enforcement Types:
    • Fraud Self-Disclosures