Oswego Hospital to pay $98K for improperly billing Medicare, Medicaid, feds say


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[MM Curator Summary]: The hospital falsified claims and said that unsupervised social workers were being supervised.


Oswego, N.Y. — Oswego Hospital has agreed to pay the federal government more than $98,000 for improperly billing Medicare and Medicaid, federal prosecutors said Wednesday.

The hospital billed the insurance programs for outpatient mental healthcare services that were conducted by clinical social workers not qualified to give the care, according to a U.S. Attorney’s Office for the Northern District of New York news release.

Under law, licensed master social workers must be supervised by a licensed clinical social worker to provide mental health services, prosecutors said. From January to May 2019, the hospital was allowing LMSWs to provide those services unsupervised and falsely claimed on forms that they were being supervised, prosecutors said.

A whistleblower who worked at the hospital first reported the violations to her supervisors but no action was taken, prosecutors said. The government and the employee took the hospital to court to resolve the violations.

Oswego Hospital agreed to settle the claims by paying $98,694. The whistleblower was awarded $19,738 from the settlement money, prosecutors said.

Staff writer Fernando Alba covers breaking news, crime and public safety. Have a tip, story idea, question or comment? Reach him at 315-690-6950, at falba@syracuse.com, or on Twitter at @byfernandoalba.

Clipped from: https://www.syracuse.com/crime/2022/10/oswego-hospital-to-pay-98k-for-improperly-billing-medicare-medicaid-feds-say.html