WATERTOWN, N.Y. (WWTI) — North Country Neurology, P.C., located in Watertown has admitted to improperly billing the federal government.
U.S. States Attorney Carla B. Freedman confirmed on August 3 that North Country Neurology agreed to pay $850,000 for was it admitted was “improper” and “reckless” billing to the federal government.
According to the U.S. Attorney’s Office, the practice admitted that it submitted 120 claims to Medicare for Botox that had been paid for by other insurers from September 2015 through June 2019.
These claims improperly listed a physician as a physician as the rendering provider, however, an investigation confirmed that no physician was present in the office.
North Country Neurology further admitted that it “knew or should have known the requirements of incident-to billing and that it was improper to submit claims to Medicare in a physician’s name for services rendered by an NPP when no physician was in the office.”
The U.S. Attorney’s Office stated that in certain circumstances, Medicare allows practices to bill for services rendered by a non-physician practitioner. However, physicians are required to directly supervise the NPP.
Additionally, the practice was found to have improperly billed Medicare for the drug Botox, when the same Botox had already been paid for by other insurers. North Country Neurology admitted that this occurred on approximately 761 occasions from March 2015 through February 2021.
After an investigation into the practice was initiated, North Country Neurology retained a third-party compliance and practice-management consultant to develop and omp[lement various practices.
The investigation and settlement were led by the United States Attorney’s Office for the Northern District of New York, HHS-OIG, and the Defense Criminal Investigative Service Northeast Field Office. The United States was represented by Assistant United States Attorney Adam J. Katz.