Oberheiden, P.C. Encourages Medicare Providers to Discuss Voluntary Self-Disclosure to CMS for Potential Billing Violations in Connection with P-Stim Devices in an Effort to Mitigate False Claims Act Liability
DALLAS, Nov. 20, 2019 /PRNewswire/ -- Due to the risk of False Claims Act investigations and corresponding liability demands, Oberheiden, P.C. is encouraging health care providers who billed Medicare for Point-Stimulation Therapy ("P-Stim") devices in the past to proactively discuss the option of a voluntary CMS self-disclosure of past billing violations with experienced attorneys.
According to Dr. Nick Oberheiden, founding attorney of Oberheiden, P.C., "Health care providers are expected to self-disclose Medicare billing violations under various circumstances. In fact, in many cases, voluntary self-disclosure can mitigate a provider's risk of facing harsh False Claims Act liability or a government investigation. As we stated previously, we are continuing to see a high volume of False Claims Act investigations across the country targeting the application of P-Stim devices. Physicians, chiropractic clinics, and other Medicare providers need to keep in mind that even inadvertent errors can trigger significant liability for recoupments, fines, costs, and treble damages."
In particular, Dr. Oberheiden suggests that Medicare-participating providers review their use of HCPCS Code L8679, CPT Code 64555, and Modifier 25 for Code L8679 before being contacted by CMS, the U.S. Attorney's Office, or the U.S. Department of Health and Human Services. For example, CMS has expressly stated that it should only be used in cases where a patient receives a "significant, separately identifiable E/M service" in connection with the implantation of a qualifying medical device. This means that the use of Modifier 25 might not be appropriate for many Medicare billings for P-Stim devices.
Oberheiden P.C. has been on the frontline of representing Medicare providers in P-Stim audits and investigations across the United States. From that experience, Dr. Oberheiden warns that health care providers need to exercise caution prior to considering interactions with federal law enforcement. "While self-disclosure may be necessary, an unthoughtful admission to a federal agency can also be dangerous; Medicare-participating providers should consult with experienced counsel to make sure that their efforts to be transparent do not unnecessarily expose them to additional CMS, DOJ, or OIG scrutiny."
Anyone who has questions is encouraged to contact Oberheiden, P.C. at 214-692-2171 or via www.federal-lawyer.com/contact for more information.
In a prior statement, Oberheiden, P.C., a federal health care fraud defense law firm based in Dallas, Texas, announced that the U.S. Department of Justice (DOJ) had accepted the firm's recommendation to appoint a national coordinator to oversee P-Stim Medicare fraud investigations under the False Claims Act to streamline concurrent investigations by different federal agencies. The firm has learned that the DOJ has not formally appointed a coordinator for P-Stim Medicare fraud investigations, contrary to what the firm announced previously.
The information contained in this statement does not constitute legal advice. Prior results do not guarantee similar outcomes. This information may constitute attorney advertising in some jurisdictions. All website disclaimers apply.
CONTACT:
Nick Oberheiden
Oberheiden, P.C.
5728 Lyndon B. Johnson Fwy. #250
Dallas, TX 75240
214-469-9009| [email protected]
www.Federal-Lawyer.com
SOURCE Oberheiden, P.C.
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