New York pain management clinic to pay $1.9M for improper billing practices — 5 insights

Syracuse-based New York Spine & Wellness Center agreed to pay the U.S. government $1.9 million for improperly billing patients and payers for “moderate sedation,” the Syracuse Post Standard reports.

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Here’s what you should know:

1. The physicians violated a 2011 rule requiring physicians spend 16 minutes of face time with patients to bill for moderate sedation. Investigators said the centers’ physicians spent less than the required time.

2. A private payer rejected claims where physician-patient face time did not last for 16 minutes.

3. U.S. Attorney Office officials said the practices stopped the improper billing and cooperated with investigators when they were contacted.

4. Around $660,000 will be returned to New York’s Medicaid program.

5. The clinic has additional offices in DeWitt, Camillus and Fayetteville, all in New York.

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