RUMFORD – Western Maine Internal Medicine has paid nearly $41,000 to the state and federal governments in a settlement involving Medicare and Medicaid services.
According to a press release issued late Monday by the U.S. attorney’s office, the settlement resolves charges the Rumford practice filed for Medicare and Medicaid services that were provided by a licensed nurse who, at the time, was excluded from participating in federal health care programs.
The settlement figure is part repayment to Medicare and part penalty. The medical practice is suing the nurse, Ann B. Bouffard of Rumford, to recoup the full sum, a lawyer for the practice said Tuesday.
According to the release, Western Maine Internal Medicine billed the federal and state governments from August 1989 to March 2002 for services provided by the nurse. The local medical practice disclosed the problem to the U.S. Department of Health and Human Services.
Dr. Albert Aniel, a medical provider at Western Maine Internal Medicine, said on Tuesday that he was disappointed by the settlement.
“We reported it and we are being punished for being honest. We’re a victim of our own honesty,” he said.
He also questioned how the the state can issue a nursing license without first learning whether the nurse had been excluded by Medicare and Medicaid.
“The employee was not truthful and she did not tell us she was on the federal excluded list,” he said. “We assumed she had a valid Maine license.”
He said the employee was fired when it was learned that she was excluded from participating in federal health care programs. He and Dr. Thomas DeLuca had worked with the nurse.
A civil claim in 11th District Court, Northern Oxford Division, was filed on June 7 against Bouffard, said Tom Dean, a Farmington lawyer who is representing the medical practice.
Bouffard could not be reached for comment on Tuesday.
The suit aims to recoup all of the funds Western Maine Internal Medicine had to pay out in repayment and penalties, Dean said.
“We believe the penalty was primarily her fault and we are seeking the full sum,” Dean said.
He said the suit would come to a pre-trial hearing no earlier than mid-October.
Under the settlement, the practice also agreed to certify annually for the next three years that it has procedures in place to prevent similar billing problems from recurring, according to the press release.
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