Part B Insider (Multispecialty) Coding Alert
CT Psychiatrist Charged with Fraud for Billing Over-the-Phone Care
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With telehealth revised and repackaged in recent CMS rulings, what is acceptable to claim is a little fuzzy for some providers.
Not all services are covered under new telehealth guidelines a Connecticut psychiatrist discovered after filing claims for advising patients via phone, a U.S. Department of Justice (DOJ) news release from July 27, 2016 suggested.
“Medicare permits certain types of ‘telehealth’ services where the patient is in a rural health professional shortage area and where the provider uses an interactive audio and video communications system that permits real-time communication between the provider and the patient,” the DOJ press release states. “However, the patients treated over the phone ...were not located in rural health professional shortage areas and [the doctor and his associates] did not use interactive audio and video communications. They simply treated certain Medicare patients by phone.”
A civil agreement in the false claims case was reached, and the Danbury physician and his associates have agreed to pay $36,704 to settle the lawsuit.
Resource: For a more in-depth viewing of the DOJ press release, visit https://www.justice.gov/usao-ct/pr/danbury-physician-and-mental-health-practice-pay-36000-settle-false-claims-act.
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CT Psychiatrist Charged with Fraud for Billing Over-the-Phone Care
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