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Medicare Final Rule Decreased Physician Payments But Expands Coverage to Counselors

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule (PFS). However, the final rule increased payment rates for outpatient services and expanded telehealth services. The rule went into effect January 1, 2024.

Physician Fee Schedule Rate Reductions; Counselors Added.

The overall payment rates under the 2024 PFS were reduced by 1.25 percent for 2024. The conversion factor is $32.74, which is a $1.15 decrease from 2023. Physicians’ Medicare reimbursements […]

By The Health Law Firm|2024-03-14T09:59:08-04:00April 15, 2024|Pharmacy Law Blog|

Medicare Final Rule Decreased Physician Payments But Expands Coverage to Counselors

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule (PFS). However, the final rule increased payment rates for outpatient services and expanded telehealth services. The rule went into effect January 1, 2024.

Physician Fee Schedule Rate Reductions; Counselors Added.

The overall payment rates under the 2024 PFS were reduced by 1.25 percent for 2024. The conversion factor is $32.74, which is a […]

Medicare Final Rule Decreased Physician Payments But Expands Coverage to Counselors

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule (PFS). However, the final rule increased payment rates for outpatient services and expanded telehealth services. The rule went into effect January 1, 2024.

Physician Fee Schedule Rate Reductions; Counselors Added.

The overall payment rates under the 2024 PFS were reduced by 1.25 percent for 2024. The conversion factor is $32.74, which is a […]

By The Health Law Firm|2024-03-14T09:59:10-04:00March 4, 2024|Mental Health Law Blog, The Health Law Firm Blog|

Psychiatric Practice, Owner Agree to Pay $310,000 in FCA Settlement for Employing Doctor on OIG Exclusion List

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric […]

By The Health Law Firm|2024-03-14T09:59:24-04:00July 31, 2023|Nursing Law Blog|

Licensed Professional Counselor Sentenced to Prison for $1.3 Million Medicaid Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 million, announced the U.S. Attorney for the U.S. District of Connecticut. In addition to the prison time, he was sentenced to three (3) years of supervised probation upon release and ordered to pay restitution to Medicaid in the amount of $1,313,322.

A Wide-Ranging Fraud Scheme.

According to court documents, from 2014 to 2020, the defendant was a licensed professional counselor with offices in Hartford, Connecticut. Additionally, he owned two entities […]

By The Health Law Firm|2024-03-14T09:59:25-04:00July 13, 2023|Mental Health Law Blog|

Psychiatric Practice to Pay $310,000 in FCA Settlement for Employing Doctor on OIG Exclusion List

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric […]

By The Health Law Firm|2024-03-14T09:59:26-04:00July 8, 2023|Pharmacy Law Blog|

Psychiatric Practice Reaches Settlement in FCA Suit to End Allegations of Employing Physician on OIG Exclusion List

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric […]

By The Health Law Firm|2024-03-14T09:59:26-04:00July 7, 2023|Health Facilities Law Blog|

Owner of Psychiatry Practice Pays Hefty Settlement in FCA Case for Employing Doc on OIG Exclusion List

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric […]

By The Health Law Firm|2024-03-14T09:59:27-04:00June 16, 2023|Dental Law Blog|

Psychiatric Practice Pays $310,000 in FCA Settlement for Employing Physician on OIG Exclusion List

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric […]

By The Health Law Firm|2024-03-14T09:59:28-04:00June 15, 2023|Mental Health Law Blog|

Court Assesses $170 Million in Fines Against Two Texas Ophthalmologists For False Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 18, 2021, the Justice Department announced that two Texas ophthalmologists and their eye clinic must pay millions of dollars in penalties for fraudulently billing Medicare. The penalties were assessed in connection with their evaluation and treatment of glaucoma.

U.S. District Judge Lynn Hughes assessed $170 million in penalties against the ophthalmologists and their eye clinic in Houston, Outreach Diagnostic Clinic.

A Former Employee Blew the Whistle.

According to the U.S. Department of Justice (DOJ), the action resulted from a False Claims Act (FCA) or “qui tam” suit. The whistleblower was […]

By The Health Law Firm|2024-03-14T09:59:30-04:00May 12, 2023|Health Facilities Law Blog, In the News|