A Rutland doctor will pay about $84,000 to settle legal claims that he defrauded the state in order to collect more money than he was entitled to from the state’s Medicaid program.
Dr. Frank Buggiani, a podiatrist who practiced in Rutland between 2008 and 2013, will pay $67,643 to Vermont’s Medicaid program and another $16,036 more to the state in a legal settlement announced Friday.
The money will settle the Attorney General’s Office’s complaint in Rutland Superior Court’s Civil Division that he tried to charge Medicaid a higher rate for making custom orthotics than he charged to commercial insurance companies.
According to the Vermont Attorney General’s Office, doctors can only bill Medicaid at a “usual and customary rate”; that rate can’t be any higher than the lowest rate the doctor charges commercial insurers or uninsured patients.
Instead, Buggiani billed Medicaid $275 per unit, or $550 per pair of orthotics, according to the settlement signed Oct. 5. He charged other payers as little $137.50 per unit, or $275 per pair of orthotics.
The state of Vermont paid Buggiani $213,252 for those Medicaid bills, according to the settlement. The state says it should have paid $137,789 for the orthotics, meaning it overpaid by $75,463.
“Dr. Buggiani cooperated with requests information and data related to the claims investigation,” the settlement said. The agreement is meant “to avoid the delay, expense, inconvenience, and uncertainty” of going to court.
