Ridgefield Doctor Will Pay to Settle Allegations

Edward Berman, MD, a physician with a practice in Ridgefield, has entered into a civil settlement with the government in which he will pay $218,633 to resolve allegations that he violated the False Claims Act.

The allegations against Berman involve fraudulent billing to Medicare for subsequent skilled nursing facility services. The government alleges that Berman submitted claims to Medicare for SNF services that were not performed in accordance with Medicare requirements.

Specifically, the government alleges that Berman “upcoded” certain services, submitting claims to Medicare by using a higher-paying billing code when services with lower-paying billing codes were actually provided.

To resolve his liability under the False Claims Act, Berman will pay $218,633, in order to reimburse the Medicare programs for conduct occurring during the time period January 1, 2008, through March 4, 2014.

“Health care providers that overcharge Medicare drain critical funds from the Medicare program and increase health care costs,” U.S. Attorney Deirdre M. Daly said in a prepared statement. “The U.S. Attorney’s office is committed to vigorously pursuing physicians and other health care providers who submit fraudulent claims to federal health care programs. Providers who submit false claims to the government face serious monetary and administrative sanctions.”

Under the False Claims Act, the government can recover up to three times its actual damages, plus penalties of $5,500 to $11,000 for each false claim.

In entering into the settlement agreement, Berman did not admit liability.