Northwestern Iowa otolaryngologist agrees to pay $1M to resolve Medicaid False Claims allegations

Local News

CAROLL, Iowa (KCAU) – An otolaryngologist with a clinic in Carroll, Iowa agreed to pay money to resolve False Claims Act allegations relating to as many as 115 procedures performed on Iowa Medicaid beneficiaries between Ocboter 13, 2014 and November 27, 2015.

Dr. Tracey Weelendorf, the otolaryngologist with a clinic in Carroll agreed to pay out $1,000,000 to resolve False Claims Act allegations.

The allegations relate to claims for endoscopic sinus surgeries. The United States alleges that the claims submitted for the procedures were improper because they did not meet the applicable medical necessity standard, or they were otherwise incorrectly coded for payment.

“Medical providers who perform unnecessary procedures or wrongfully code claims violate the public trust. This settlement is another indication of our office’s dedication to vigorous enforcement of False Claims Act and our unyielding effort to protect patients, save taxpayer money, and ensure a fair marketplace for honest practitioners,” said Teter E. Deegan, Jr. The United States Attorney for the Northern District of Iowa.

In addition to Dr. Tracey Weelendorf paying the $1,000,000 settlement, he also entered into an Integrity Agreement with the Department of Health and Human Services Office of Inspector General, which requires Dr. Weelendorf to engage in enhanced compliance measures for the next three years.

“Medically unnecessary services pose potential harm to patients and place needless burdens on taxpayers who fund government health programs. HHS OIG entered into an integrity agreement requiring Dr. Weelendorf submit three years of intensive quarterly monitoring by an independent review organization,” said Curt Muller, Special Agent in charge for the Office of Inspector General of the U.S. Department of Health and Human Services.

The matter arose from an affirmative investigation. False Claims Act cases can also be brought under the qui tam provisions of the Act, which encourage whistleblowers to bring forward on behalf of the United States and share in any financial recovery.

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