Apex Medical Group, d/b/a Nephrology Consultants, will pay $4.36 million to resolve allegations of upcoding physicians’ services and affiliated dialysis services. Additionally, according to DoJ, “Apex and Dr. Naseemul Siddiqi have entered into a comprehensive five-year Integrity Agreement with the Office of Inspector General of the U. S. Department of Health and Human Services to ensure the future compliance of the Apex with federal health care benefit program requirements.” Prosecutors maintain that the entities’ practices “violated the federal False Claims Act, the Tennessee Medicaid False Claims Act, and other federal and state laws and regulations.” The investigation was prompted by an insider who alerted DoJ to the allegedly fraudulent practices. The whistleblower will receive a substantial award for exposing the alleged fraud under the qui tam provisions of the federal False Claims Act.

To report dialysis fraud or other Medicare or Medicaid fraud, contact Frohsin & Barger.