Report on Medicare Compliance 29, no. 16 (April 27, 2020)
◆ The HHS Office of Inspector General (OIG) has proposed a rule on civil monetary penalties (CMPs) for information blocking and fraud related to HHS grants, contracts and other agreements.[1] OIG also proposed to adjust the maximum penalties for various CMP violations.
◆ HHS’s Health Resources and Services Administration has a new website for telehealth. Visit https://telehealth.hhs.gov/.
◆ In an audit of 100 psychotherapy services billed to Medicare in 2017 and 2018, OIG said Grand Desert Psychiatric Services in Las Vegas, Nevada, only billed one of them correctly.[2] As a result, Grand Desert was overpaid $5,173, which OIG extrapolated to $421,272. OIG contended that Grand Desert didn’t document the time spent on psychotherapy, the services didn’t comply with incident-to billing requirements or psychotherapy wasn’t provided as documented.
◆ Orthopedic surgeon Jeffrey R. Carlson has agreed to pay $1.75 million to settle a false claims case over allegations he accepted kickbacks from SpineFrontier Inc., a Massachusetts-based medical device manufacturer, the U.S. Attorney’s Office for the District of Massachusetts said April 24.[3] Carlson is the sixth surgeon to settle a case in connection with SpineFrontier. The U.S. attorney’s office filed a False Claims Act complaint in March against SpineFrontier and its executives, alleging the company paid kickbacks to spine surgeons directly and through a sham third party, Impartial Medical Experts LLC, which was owned by SpineFrontier’s founder and CEO, Kingsley R. Chin.
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