Violation Tracker Individual Record

Company: 
University of California San Francisco Health d/b/a UCSF Medical Center
Current Parent Company: 
University of California
Penalty: 
$1,443,016
Year: 
2016
Date: 
September 28, 2016
Offense Group: 
healthcare-related offenses
Primary Offense: 
HHS civil monetary penalties
Violation Description: 

On September 28, 2016, University of California San Francisco Health d/b/a UCSF Medical Center (UCSF), entered into a $1,443,016 settlement agreement with OIG. The settlement agreement resolved allegations that UCSF submitted claims for "new patient" evaluation and management outpatient clinic visits using Healthcare Common Procedure Coding System (HCPCS) codes 99203-99205 when the patients at issue were actually "established patients" and, thus, UCSF should have submitted those claims using the lower-paying HCPCS codes 99213-99215.

Level of Government: 
federal
Action Type: 
agency action
Agency: 
Health & Human Services Department Office of Inspector General
Civil or Criminal Case: 
civil
Facility State: 
California
Facility City: 
San Francisco
HQ Country of Parent: 
USA
HQ State of Parent: 
California
Ownership Structure of Parent: 
government-owned
Major Industry of Parent: 
miscellaneous services
Specific Industry of Parent: 
university
Source Notes: 
If an online information source is not working, check the Violation Tracker Data Sources page for an updated link.
Parent company note: 
Parent-subsidiary relationship is current as of the most recent revision listed in the Update Log.