Essex County Health Group Agreed to Pay $477,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services that Were Not Medically Necessary or Failed to Meet Coverage Criteria

After it self-disclosed conduct to OIG, Essex County Health Group, PC (Essex), West Orange, New Jersey, entered into a $477,550.85 settlement agreement with OIG. The settlement agreement resolves allegations that Essex submitted claims to Medicare and Medicaid for CPT codes 99223, 99232, and 99233, which did not meet medical necessity requirements or otherwise did not meet coverage criteria.