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Attorney General's News Release

September 21, 2010

Attorney General Koster obtains $200,000 settlement in Medicaid fraud case

Jefferson City, Mo.- Attorney General Chris Koster today announced his office has reached a settlement with Teresita Manubay, M.D., a pediatrician practicing in Kennett, Missouri. The settlement resolves allegations concerning her Medicaid billing practices during a period of time beginning January 1, 2008, thru March 31, 2010, and assurances that Manubay will bill correctly in the future.

The Medicaid Fraud Control Unit of the Attorney General alleged that Dr. Manubay, during the period in question, was improperly billing an office visit procedure code for preventive/routine well child checks, which resulted in billing for services that were not rendered in the amount of $65,018.49. Although Dr. Manubay contends that she did provide some services, she acknowledged that her billing practices were inadequate. She also acknowledged being previously counseled about her erroneous billing practices by the Department of Social Services.

Today's agreement requires Dr. Manubay to pay $65,018.49 in restitution; a civil penalty of $130,036.98; and $5,000 for investigation costs, totaling $200,055.47. Additionally, Dr. Manubay is required to:

Retain an independent M.D. practice auditor to review her Medicaid billings for the next 18 months;

Pay for any incorrect or billing errors, applying the 3X damages formula to any overpayment the auditor determines;

Hire, or have trained, a certified professional Medicaid coder to do her billings; and complete provider education training in proper documentation of patient files.

"One of my top priorities as Attorney General is fighting Medicaid fraud," Koster said. "The Attorney General's Office will continue to seek to recover money for Missouri taxpayers that has been fraudulently taken from the system."

Koster said citizens should report suspected Medicaid provider fraud or abuse and neglect to his Medicaid Fraud Hotline toll free at 800-286-3932, e-mail the complaint or complete a complaint form.

 



 
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