Problem
Case Study
Note: In each CMP case resolved through a settlement agreement, the settling party has contested the OIG's allegations and denied any liability. No CMP judgment or finding of liability has been made against the settling party.
May 15, 2007
Lee R. Rocamora, M.D., North Carolina, agreed to pay $ 106,600 to resolve his liability for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the practitioner requested payments from Medicare beneficiaries in violation of his assignment. Specifically, the practitioner allegedly asked his patients to enter into a membership agreement for his patient care program, under which the patients paid an annual fee. In exchange for the fee, the membership agreement specified that the practitioner would provide members with:
i. An annual comprehensive physical examination
ii. Same day or next day appointments
iii. Support personnel dedicated exclusively to members
iv. 24 hours a day and 7 days a week physician availability
v. Prescription facilitation
vi. Coordination of referrals and expedited referrals, if medically necessary
vii. Other service amenities as determined by the practitioner.