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HMO Sues M.D. for Fraud
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Business New Haven
11/10/2003
By: BNH
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| SHELTON - HMO Health Net of the Northeast has filed suit against a Stamford physician, health center and surgical and laser facility for allegedly defrauding it of more than $1 million in claims. The suit alleges that Carol Upright, the Women's Health & Wellness Center Inc. and the New England Surgical & Laser Pavilion Inc. intentionally misrepresented services involving laser removal work. According to the lawsuit, from 1994 to July 2002, Upright billed for services she claimed to have provided either in her name or the other two entities listed in the suit. The legal action asserts that Upright billed under codes where medical records did not exist and/or billed Health Net for patients without symptoms to justify performing such services as laser hair removal.
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