Doctors paying $145,000 in probe

David Strow

Friday, Nov. 9, 2001 | 11:05 a.m.

A Florida-based physician management group has agreed to pay the state of Nevada $145,000 to settle overbilling investigations by the state attorney general's office.

Pediatrix Medical Group revealed Thursday it paid $110,000 in April to settle overbilling claims made against a Nevada-based physician practice before it was acquired by Pediatrix subsidiary Obstetrix Medical Group Inc. A second payment of $35,000 was made in October to settle "any potential claims related to certain Medicaid billings for neonatology, newborn and pediatric services."

The company did not admit wrongdoing, and said it agreed to settle "as part of a desire to avoid the time and expense of litigation associated with the disputed claims." The investigation had been under way in Nevada for at least three years, Nevada officials said.

Pediatrix is a national physician management group specializing in neonatal and fetal/maternal medicine. It employs more than 570 physicians nationwide.

Medicaid is a public healthcare assistance program for low-income residents funded by the federal government and individual states. The state administers the program and makes payments to participating physicians.

Timothy Terry, director of the attorney general's Medicaid Fraud Control Unit, said the $145,000 payment will allow the state to fully recover the amount of the alleged overbilling and the cost of the investigation, and includes some civil penalties.

He called the size of the overbilling "on the low end of the spectrum," noting a recent settlement with Charter Behavioral Health that netted the state $2 million.

"If it was really bad, they could have been criminally charged," Terry said. "There wasn't a criminal case here, and that's why it was resolved civilly."

Pediatrix has previously settled similar claims in Arizona and Florida and faces investigations in other states.

"Based on the settlements reached in Florida, Arizona and Nevada, the company remains confident that its billing practices are appropriate," the company said in a statement.