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Provider ALERT: Open Payments Review Period Begins April 1st

The Open Payments program collects and publishes data regarding financial relationships between the healthcare industry, including applicable drug and device manufacturers and GPOs, and healthcare providers ("Covered Recipients") on a publicly accessible website that enables consumers of health care to search, download, and evaluate the reported data. The law that gave rise to the program is commonly referred to as the Physician Payments Sunshine Act, or simply the "Sunshine Act."  ...

Owners of Several Dental Clinics Face Prison Terms

The owners of several Missouri dental clinics were recently convicted for defrauding the government by submitting false claims to Medicaid and failing to pay payroll taxes. The owners, who are a married couple, operated three All About Smiles LLC dental clinics and a separate management company. In a collaborative effort, the Department of Health and Human Services – Office of Inspector General, the Missouri Attorney General’s Office Medicaid Fraud Control...

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...

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 Appeals Payor’s Termination of Physician

Frier Levitt recently represented a physician facing termination as a participating provider with a major commercial payor due to a medical malpractice settlement that was deemed to indicate a quality of care issue. With the payor's members comprising the majority of the physician's patient population, a termination of his provider contract would have devastated his practice and the community he serves. Frier Levitt assisted the physician in appealing the termination...