CMS selects primary care payment model participants According to Becker's Hospital Review, "CMS chose 916 primary care practices and 37 regional health plan partners as participants in its new payment model called Primary Care First. PCF was designed to decrease the amount of avoidable hospital visits and total cost of care through performance-based adjustments. The [...]

OIG Tags Arizona Hospital for Erroneous Billing Flagstaff (Ariz.) Medical Center failed to comply with Medicare billing requirements for three of 100 inpatient and outpatient claims reviewed by HHS' Office of Inspector General, according to an OIG report. The three claims that did not comply with Medicare billing requirements resulted in Flagstaff Medical Center receiving [...]

Neurosurgeon Medical Practice Director to Pay Over $1 Million Neurosurgeon Medical Practice Director to Pay Over $1 Million to Resolve False Claims Act Liability Arising from Billing of P-Stim Devices. PHILADELPHIA – First Assistant United States Attorney Jennifer Arbittier Williams announced that neurosurgeon Sagi M. Kuznits, practice director Pnina Kuznits, and Neurosurgical Care LLC (collectively, [...]

New Mexico Physician and Practice Settle Case Involving False Claims The settlement agreement resolves allegations that Dr. Reddy submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 93965, when those claims were for a procedure that was already included as a component of the duplex ultrasound procedures for which Dr. Reddy submitted claims using [...]

Texas Physician and Practice Settle Case Involving False Claims The settlement agreement resolves allegations that Dr. Robbins submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 93965, when those claims were for a procedure that was already included as a component of the duplex ultrasound procedures for which Dr. Robbins submitted claims using HCPCS [...]

Illinois Physician Settles Case Involving False Claims The settlement agreement resolves allegations that Dr. Tolitano submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 93965, when those claims were for a procedure that was already included as a component of the duplex ultrasound procedures for which Dr. Tolitano submitted claims using HCPCS codes 93970 [...]

Pain doctor pays to settle allegations of deceptive Medicare billing. A 52-year-old pain management physician from Houston has paid $530,000 to resolve allegations he falsely billed Medicare for the use of electro-acupuncture devices, announced U.S. Attorney Ryan K. Patrick. From March 1, 2019, to Oct. 31, 2019, Dr. Syed Nasir billed Medicare for the implantation [...]

Tallahassee Health Care Provider Arrested for Medicaid Fraud A Tallahassee health care provider has been arrested for billing the Florida Medicaid Program around $50,000 for fraudulent medical services, according to Florida Attorney General Ashley Moody. Rodney Burt, 57, was arrested Friday on Medicaid fraud charges after he billed the state’s Medicaid program for phony services [...]