North Country Neurology ordered to pay $850K for ‘improper,’ ‘reckless’ billing

WATERTOWN, N.Y. (WWTI/NEWS10) — North Country Neurology, P.C., located in Watertown has been ordered to pay hundreds of thousands of dollars by the United States Attorney’s Office. United States Attorney Carla B. Freedman said on August 3 that North Country Neurology will pay $850,000 for what it admitted was “improper” and “reckless” billing to the federal government.

The practice reportedly 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 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 said 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 about 761 times 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 implement 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.

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