Dr. Joseph Upton, a Bellevue doctor, has agreed to pay over $65,000 to settle allegations of submitting false claims to federal healthcare programs. The U.S. Department of Justice announced that his actions resulted in fraudulent billing of Medicare by signing orders for unnecessary medical equipment and genetic testing services.
The settlement includes $32,840 for restitution, with the rest as a penalty under the False Claims Act, though specific details were not provided by the U.S. Attorney's Office. Allegations indicate that between August 1, 2018, and April 30, 2019, Dr. Upton signed orders for medical equipment and genetic testing for Medicare patients without ever meeting or communicating with them, which is required by Medicare guidelines.
"Our federal health care system relies on the basic principle that providers must bill properly and follow the rules, and the taxpayers who fund the Medicare and Medicaid programs deserve nothing less," said Special Agent in Charge Steven J. Ryan of the U.S. Department of Health and Human Services Office of Inspector General in a statement obtained by the Department of Justice. The investigation targeted schemes that potentially harm the integrity of telehealth services, which have become an increasingly important component of patient care.
Ryan affirmed the commitment to protecting federal health care programs from fraud, particularly against schemes that undermine legitimate telehealth services. The settlement does not imply liability but resolves the claims made by the U.S. government. The case was prosecuted by Assistant U.S. Attorney Ashley Burns and investigated by the HHS Office of Inspector General.
