Clinic agrees to reimburse Medicare for improper billing related to neurostimulators

Health Care Compliance Association (HCCA)
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Health Care Compliance Association (HCCA)

Compliance Today (March 2021)

A Texas spine clinic “has agreed to pay $330,898.00 to resolve liability under the False Claims Act for the alleged improper billing of electro-acupuncture device neurostimulators,”[1] U.S. Attorney Stephen J. Cox recently announced. For approximately 10 months, the Spinal Decompression Clinic of Texas “billed Medicare for the implantation of 41 neurostimulators – a surgical procedure which,” the government report notes, “usually requires an operating room and is reimbursed by federal healthcare programs.” The clinic, based in Longview, “did not perform these surgeries, and instead applied P-Stim devices in an office setting, without surgery or anesthesia.”

Medicare will not pay for or reimburse for “acupuncture or for acupuncture devices such as P-Stim, nor does Medicare reimburse for P-Stim as a neurostimulator or as implantation of neurostimulator electrodes,” according to the announcement.

“Falsely submitting claims for non-covered services robs from the Medicare program and thereby deprives those in need from vital resources,” said Cox.

1 U.S. Department of Justice, U.S. Attorney’s Office for the Eastern District of Texas, “Texas Company Agrees to Reimburse Medicare for Improper Billing Related to Neurostimulators,” news release, January 12, 2021, http://bit.ly/38IShkt.

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