Baby-care firm settles Medicaid claims

September 22, 2006|By Douglas Birch | Douglas Birch,Sun reporter

A Florida corporation that provides pediatric physician and nursing services to 32 states, including Maryland, agreed yesterday to pay $25 million to settle claims the company billed the federal government for critical care for infants who were not critically ill.

Rod J. Rosenstein, U.S. attorney for Maryland, said in a statement that Pediatrix Medical Group Inc. of Sunrise, Fla., had "upcoded" reimbursement claims to the government under the Medicaid program for services rendered by pediatricians, nurses and other specialists from January 1996 to December 1999.

During that period, the statement said, as many as a third of the infants Pediatrix employees labeled as critically ill on admission to neonatal intensive-care units were not critically ill.

Pediatrix denied any wrongdoing yesterday. "There was no concerted effort to do anything outside the rules and regulations," said Bob Kneeley, a spokesman for the company.

Pediatrix, founded in 1979, provides services through 860 physicians and 350 advanced nurse practitioners. The case was filed against the company in 2002.

The investigation was led by Rosenstein and Troy Eid, U.S. attorney for Colorado, and conducted by Medicaid fraud control units in Maryland, Colorado and three other states.

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