Vermont Business Magazine A Rutland podiatrist will pay the State of Vermont in excess of $83,678 to settle claims that he obtained payments from the Vermont Medicaid Program to which he was not entitled. The provider, Dr. Frank Buggiani, offers podiatry services and orthotic devices to patients. The settlement resolves a civil complaint filed in Rutland Superior Court, Civil Division in December 2014 by the Medicaid Fraud and Residential Abuse Unit of the Office of the Attorney General. The complaint related to the submission of Medicaid claims by Dr. Buggiani for custom orthotic devices. An investigation identified that Dr. Buggiani’s claims to Medicaid for custom orthotic devices were at a rate that exceeded the rate that he charged to other insurers. Medicaid rules and provider contracts require that providers bill Medicaid their “usual & customary rate” that isnot to exceed the lowest rate charged to other insurers or patients. The higher rates submitted by Dr. Buggiani resulted in the Vermont Medicaid Program making overpayments to Dr. Buggiani. Dr. Buggiani cooperated with the investigation.
Under the settlement agreement, Buggiani will repay $67,643.46 to the Vermont Medicaid program and also pay $16,035.51 in additional recoveries to the State. A copy of the settlement is available via the link below. The Medicaid Fraud and Residential Abuse Unit was assisted by the Program Integrity Unit of the Department of Vermont Health Access in obtaining this settlement.