COLUMBUS, Ohio (WCMH) — Three central Ohio health providers will pay a settlement totaling $3 million after one doctor submitted improper claims for surgeries that either weren’t performed or took less time than was billed.
The three health providers — Mount Carmel Health System, Orthopedic & Neurological Consultants (OrthroNeuro), and the New Albany Surgery Center (NASC) — were ordered to pay after the improper claims were submitted to Medicare and the Ohio Bureau of Workers’ Compensation (BWC).
OrthoNeuro doctor and part-owner Robert Nowinski, who is dead, is said to have routinely billed for complex, time-consuming shoulder surgeries that he spent a fraction of the time in the operating room to complete or did not occur at all.
Nowinski also used operating facilities at NASC and Mount Carmel’s New Albany Surgical Hospital with both billing “facility fees” to Medicare and Ohio BWC relating to surgeries allegedly performed.
The government concluded that while the settling parties did not submit false claims on purpose from Nowinski’s surgeries, there was evidence that the service providers should have received notice of the improper billing.
The three Central Ohio health providers will pay these amounts in the settlement:
- OrthoNeuro ($498,182 to Medicare, $533,482 to BWC)
- NASC ($772,650 to Medicare, $468,406 to BWC)
- Mount Carmel ($760,901 to Medicare, $156,139 to BWC)