08-19-2016 Pennsylvania Audiology Practice Agrees to Voluntary Exclusion

On August 19, 2016, in connection with the resolution of False Claims Act liability, John Balko & Associates, Inc. d/b/a Senior Healthcare Associates (SHA), agreed to be excluded from participation in all Federal health care programs for a period of ten years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that SHA knowingly and intentionally submitted or caused to be submitted claims for payment to Medicare for cerumen removal procedures, nail debridement procedures, and evaluation and management services using modifier-25, which were not medically necessary, were not authorized or requested by patients, were not supported by patient medical records, lacked required medical documentation, and/or were provided in reliance upon improper standing orders.