The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.
Supportive Care’s companies operate in multiple states including Connecticut, Pennsylvania and Virginia. The settlement with the government was based on allegations of improperly billing HCPCS Q3014 (telehealth originating site facility fee). The code permits reimbursement for a facility fee along with a professional fee for psychological services provided under certain conditions.
The billing code is applicable only for patients who are residents in nursing homes, but the Supportive Care companies allegedly billed facility fees even for patients who were inpatients in acute care hospitals. The settlement covers claims submitted from 2019 through 2023.
This settlement demonstrates the importance of accurate claims submissions to payers, especially government payers. Understanding and documenting precisely what needs to be included in a patient chart to support each code billed is essential.
Sign up to receive Rivkin Rounds at www.RivkinRounds.com.