Attorney General James Secures Over $2 Million in Medicaid Settlement from Western New York Doctor to Resolve Findings of Illegal Billing

Attorney General James Secures Over $2 Million in Medicaid Settlement from Western New York Doctor to Resolve Findings of Illegal Billing

NEW YORK – New York Legal professional Normal Letitia James today introduced that her workplace has reached a civil settlement with Dr. David B. DiMarco, M.D. and his organizations D.B. DiMarco, M.D., P.C. (D.B. DiMarco) and DiMarco Vein Centers LLC (DiMarco Vein Centers), securing extra than $2 million for Medicaid. The settlement resolves an investigation by the Business of the Attorney Common (OAG) into unlawful Medicaid billing techniques for vein treatment options executed by Dr. DiMarco. The OAG observed that Dr. DiMarco submitted a lot more than 1,000 promises for strategies to Medicaid with no enough documentation to show what strategies ended up truly executed or why the methods have been medically essential, ensuing in overpayment of Medicaid reimbursement. As a result of the settlement declared right now, DiMarco will pay $2,139,037 to Medicaid and he will also withdraw from the New York Point out Medicaid plan.

“When vendors scam Medicaid, they just take assets and medical care away from New Yorkers in need to have,” claimed Lawyer Standard James. “My business office investigated Dr. DiMarco’s illegal billing tactics, and now we are returning additional than $2 million in critical funding to the Medicaid method. My office will proceed to maintain Medicaid companies accountable to be certain we defend the integrity of this crucial application.”

Dr. DiMarco owns D.B. DiMarco and DiMarco Vein Facilities, healthcare techniques with many destinations in Western New York, which include Lakewood, Olean, and Ellicottville.

The OAG uncovered that, concerning March 2015 and October 2021, Dr. DiMarco submitted claims to Medicaid for strategies with out sufficient documentation. The OAG investigation into these promises identified that Dr. DiMarco’s records did not present which methods had been basically executed, nor did they suggest why the methods have been medically required and therefore suitable for Medicaid reimbursement.

The investigation was initiated by MFCU Lead Facts Scientist Si Lok Chao, below the supervision of Director of Information Analytics Michael Wassell, and was done by Investigate Analyst Brandon Andrews and Detective Investigator Chris Canfield, underneath the supervision of Detective Supervisor James Zablonski and Deputy Chief Investigator William Falk. Both equally the investigation and settlement had been taken care of by Unique Assistant Lawyers Typical Soo-young Chang of the MFCU Buffalo Regional Office environment and Logan J. Gowdey of the MFCU Civil Enforcement Division. The Buffalo Regional Business is led by Buffalo Regional Director Maura O’Donnell and the Civil Enforcement Division is led by Civil Enforcement Division Chief Alee N. Scott. MFCU is a portion of the Division for Prison Justice and is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. The Division for Felony Justice is overseen by Chief Deputy Legal professional General José Maldonado and Initial Deputy Legal professional Common Jennifer Levy.

Reporting Medicaid Provider Fraud: MFCU defends the public by addressing Medicaid supplier fraud and protecting nursing property people from abuse and neglect. If you have facts about Medicaid supplier fraud or know about abuse or neglect of a nursing property resident, make sure you file a confidential grievance on line or call the MFCU hotline at (800) 771-7755. If the problem is an crisis, you should simply call 911.

New York MFCU’s full funding for federal fiscal yr (FY) 2023 is $65,717,936. Of that complete, 75 percent, or $49,288,452, is awarded below a grant from the U.S. Section of Health and Human Providers. The remaining 25 {c024931d10daf6b71b41321fa9ba9cd89123fb34a4039ac9f079a256e3c1e6e8}, totaling $16,429,484 for FY 2023, is funded by New York state. Through MFCU’s recoveries in legislation enforcement steps, it routinely returns extra to the condition than it gets in condition funding.