Blog

Dental Entities Garner “High-Risk” Status from DHHS’ OIG

The Federal and Indiana State government recently announced that ImmediaDent of Indiana, LLC, and its administrative services provider, Samson Dental Partners, LLC, agreed to pay more than $5.1 million to settle allegations that they submitted false claims to Indiana's Medicaid program. The parties agreed to the financial settlement without admitting any wrongdoing and notably, without entering into an Integrity Agreement (IA) and/or Corporate Integrity Agreement (CIA).  The Department of Health...

PHARMACY ALERT: PSAO EPIC Pharmacies Sends Notice of GER Deductions

Pharmacy Services Administrative Organization (PSAO) EPIC is sending out a "Notice of GER Deductions" to pharmacies in its network advising that the pharmacy's reimbursements have been running in excess of the contracted Generic Effective Rate (GER) amount. The Notice warns the pharmacy that the monetary sum in excess of the contracted GER amount will be withheld and that EPIC will provide details regarding the deducted amounts upon requests. It is...

Dental Practice and DSO to Pay $5.1 Million to Settle False Claims Allegations

The Federal and Indiana State government recently announced that two dental firms agreed to pay more than $5.1 million to settle allegations that they submitted false claims to Indiana's Medicaid program. ImmediaDent of Indiana, LLC, and its administrative services provider, Samson Dental Partners, LLC, were accused of billing straightforward tooth pullings as surgical operations and billing for deep cleanings that were either not required and/or performed. According to the settlement,...

Frier Levitt Successfully Reduces Recoupment from Physician’s Medicaid Audit

A New Jersey otolaryngologist was facing a large recoupment as the result of an audit by the New Jersey Medicaid Fraud Division (MFD) of the Office of the State Comptroller. In the audit, the MFD claimed that the physician was an outlier for billing too many consultation codes. Frier Levitt successfully showed that the otolaryngologist's documentation supported the use of consultations codes and that there was no basis to initiate...

What Healthcare Providers Need to Know About New Jersey’s New PTO Mandate

Earlier this year, New Jersey joined the list of many states enacting a statewide mandatory paid sick leave law. The New Jersey Paid Sick Leave Act (the Act), effective as of October 29, 2018, requires all "covered employers" to provide up to forty (40) hours of annual sick leave to their employees. The recent mandate marks a significant development for employers and employees in the state as it may require...