Kentucky Allergists Agree To Pay $740,578 To Resolve False Claims

Settlement covers alleged improper billing

LOUISVILLE, Ky. – Kentucky allergists Bruce Wolf and Kiro John Yun, have agreed to pay $740,578 to resolve alleged violations of the False Claims Act, announced United States Attorney John E. Kuhn, Jr. Wolf and Yun, P.S.C. (W&Y) is a medical practice group of otolaryngologists specializing in allergy, asthma and immunology with offices located in Bardstown, Elizabethtown and Leitchfield, Kentucky. The government alleged that W&Y submitted false claims when billing Medicare, TRICARE and the Federal Employees Health Benefits Program (FEHBP).

“Losses caused by health care fraud amount to tens of billions of dollars every year,” said U.S. Attorney John Kuhn, of the Western District of Kentucky. “Often those losses are passed along to consumers in the form of increased costs. For that reason, my office will work with federal, state, and local law enforcement to uncover these activities and recover every dollar.”

The settlement resolves the government’s allegations that W&Y improperly billed Medicare, TRICARE and FEHBP for Sublingual Immunotherapy serum preparation and overstated units of serum preparation for injection vials, under CPT Code 95165, and for testing under CPT Code 95024 during the following periods of January 1, 2010, and October 31, 2015 for Medicare; between June 1, 2010, and September 30, 2015, for TRICARE: and between January 1, 2010, and August 31, 2015 for FEHB.

Sublingual immunotherapy (SLIT), is an alternative way to treat allergies without injections whereby an allergist prescribes a patient with an allergen that is sprayed under the tongue to boost tolerance to substances and reduce symptoms. SLIT treatments are not covered by Medicare and other payors because it is considered investigational and thus not a billable procedure.

This case was investigated by the United States Attorney’s Office for the Western District of Kentucky and was prosecuted by Assistant United States Attorney Ben Schecter of the Western District of Kentucky.