Comprehensive Psychiatric Services will pay $2.75 million after allegations of submitting false insurance claims between January 1, 2015 and December 31, 2022. The Department of Justice alleges company providers billed using add-on codes when psychotherapy services accompanied evaluation and management visits, but used those codes when services were not provided or inadequately documented. The settlement directs $2.6 million to the U.S. government and $134,430 to the state of California because all claims were submitted to government payors. Federal program participation requires accurate billing for care actually rendered; improper billing drains taxpayer-funded resources.
Between Jan. 1, 2015 and Dec. 31, 2022, the DOJ alleges that the company and its health care providers submitted insurance claims using add-on codes when psychotherapy services are performed with an evaluation and management visit, according to the news release. However, the DOJ claims that the codes were used when the services hadn't been provided or weren't adequately documented.
Comprehensive Psychiatric Services will pay $2.6 million to the United States government and $134,430 to the state of California as all claims were submitted to government payors. Providers that participate in federally funded health care programs must abide by the rules and submit proper claims for care that was in fact rendered, United States Attorney Craig H. Missakian said in the news release. To do otherwise is to drain resources from our fellow Americans who rely on Medicare and other government programs.
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