Health Law Alert by Lamb McErlane attorneys: Vasilios J. Kalogredis, Esq. and Sonal Parekh, Esq.

On February 7, 2024, the U.S. Attorney’s Office for the Middle District of Pennsylvania announced that Penn State Health (“PSH”) agreed to pay over 11 million dollars to settle allegations of submitting claims to Medicare for Annual Wellness Visit (“AWV”) services in violation of Medicare rules and regulations. Specifically, through a voluntary disclosure, PSH divulged that it submitted claims to Medicare for AWV services that were not supported by the applicable medical record over a period of approximately 7 years.

PSH submitted the self-disclosure promptly on discovering the violation. This is the second time in the span of a year that PSH has settled to pay over a million dollars after self-disclosing improper Medicare billing. This time, to resolve the allegations of liability, the multi-hospital health system has agreed to pay almost 10 times the amount it paid last year, totaling an amount of $11,712,336.

If you have any questions regarding Self-Disclosure or whether you or your company are in compliance with Medicare rules and regulations, please feel free to contact Bill Kalogredis, Esq. or Sonal Parekh, Esq.

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Vasilios J. (Bill) Kalogredis, Esq. has been advising physicians, dentists, and other healthcare professionals and their businesses as to contractual, regulatory and transactional matters for over 45 years. He is Chairman of Lamb McErlane PC’s Health Law Department. Bill can be reached by email at bkalogredis@lambmcerlane.com or by phone at 610-701-4402.

Sonal Parekh, Esq., is an associate at Lamb McErlane PC who focuses on healthcare transactional matters and a broad range of healthcare regulatory-related issues on behalf of healthcare systems, physicians, dentists, and other healthcare providers, and is a pharmacist by education and training. Sonal can be reached by email at sparekh@lambmcerlane.com or by phone at 610-701-4416.

*This alert is for educational purposes only and is not intended to be legal advice. Should you require legal advice on this topic or have any questions or concerns, contact Vasilios J. (Bill) Kalogredis, Esq. or Sonal Parekh, Esq.