Author Topic: NYS Medicaid Hitting Providers Who Pay % To Billing Services  (Read 514 times)

Michele

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Hey do we have any NY Billing Services out here that are receiving letters from the Attorney General regarding charging a % to their providers?  Back in December many NYS Billing Services received letters from the Medicaid Fraud and Waste Department and the Attorney General's office asking them to send in a list of all providers that they bill for/or did bill from from 1/1/2010 to present and the method that they charged them for that billing.  Once they received the letters, any providers that paid a % to their billing service received a letter advising them that they had to pay some of the money they received back to NYS Medicaid.  Just curious where other billing services are in this process and what experiences they are having.

Anyone willing to share, please let us know how you are making out.
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PMRNC

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Re: NYS Medicaid Hitting Providers Who Pay % To Billing Services
« Reply #1 on: June 30, 2017, 02:38:14 PM »
YES.. and I've even had members who had billing companies in OTHER states get this letter because they service providers in NY.

It's been a long time coming as NY billing companies should have always known that it was illegal for providers in NY to engage in fee-splitting, they are just now getting around to finding these companies and clarifying consequences for the providers.

If you are a NY billing company OR a billing company servicing NY providers it's a great marketing tool so long as your not charging a %.
Linda Walker
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Michele

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Re: NYS Medicaid Hitting Providers Who Pay % To Billing Services
« Reply #2 on: July 01, 2017, 03:13:47 PM »
Do you know anything about Bill S4736?  I can't find anything recent on it.  I know we've all known about % billing being fee splitting and many of us believe it's not the best method for charging but I still don't agree with how this is being handled.  We know of several billing services that this is hitting hard.  One has over 50 employees.  I hate to see people lose their businesses and their jobs.  Even as I'm writing this that little voice is saying "but they knew....."  I know, just still not happy with how they are addressing it.  The providers are the ones being hurt the most. 
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PMRNC

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Re: NYS Medicaid Hitting Providers Who Pay % To Billing Services
« Reply #3 on: July 13, 2017, 08:26:41 AM »

Quote
Do you know anything about Bill S4736?  I can't find anything recent on it.

The wheels of justice grind slowly...it appears it's stalled: http://assembly.state.ny.us/leg/?default_fld=%0D%0A&leg_video=&bn=S04736&term=2015&Summary=Y&Actions=Y&Text=Y  last action was June, 2016. Now if you do a further search of S4736 you'll see that same Bill # as well as S4736 relate to 911. That tells me the bill to amend the fee-splitting provision died and that happens a lot with the bill # being reassigned.

I can't feel bad for any billing company or physician because this is something we in NY have all KNOWN about for ages..YEARS and years.  The billing company hasn't done anything wrong under the actual bill of record, but the provider(s) that have contracts based on fee-splitting arrangements HAVE. When they are fined and sanctioned who do you think they are going to be madder at? The law they broke or the billing company that provided them the contract w/out telling them? Unfortunately the billing company is going to be the escape goat. On a flip side of that any of us that DID let providers know now have the competitive edge for doing the right thing to begin with so that is a plus for those of us who DID know or even took the time to learn about. How can you have NOT known about this when it's been talked about for MANY MANY MANY years? When you open and operate ANY business you have a responsibility to research rules. It's my feeling that these billing companies DID know but also didn't care because it wasn't THEM violating any law, only now it's going to bite them in the rear end. And SHAME on any lawyer representing a physician that did look over their clients contracts (AS THERE SHOULD HAVE BEEN) and didn't bring this to their clients attention!

Nope, no feeling bad on this one. It's about to happen in Florida too now.

Linda Walker
Practice Managers Resource & Networking Community
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www.billerswebsite.com

Michele

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Re: NYS Medicaid Hitting Providers Who Pay % To Billing Services
« Reply #4 on: July 15, 2017, 03:19:17 PM »
I agree, I guess I'm just a softee.  We have told people over and over.  We have told providers.  We actually had a neurologist specifically contact us because we charge a flat fee and all of the previous services she contacted were a %.   :-\
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PMRNC

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Re: NYS Medicaid Hitting Providers Who Pay % To Billing Services
« Reply #5 on: July 15, 2017, 04:47:27 PM »
Quote
We actually had a neurologist specifically contact us because we charge a flat fee and all of the previous services she contacted were a %

AGREE..it's a GREAT marketing tool for those of us who have been ethical and up-front with providers. This law has been on the books for a VERY long time in NY, so my feeling is that any billing company that didn't modify their contracts so physicians wouldn't be on the hook did a dis-service to their clients. More business for us and now with them cracking down, it's even better. The billing company can't get into trouble but I wouldn't expect those physicians under % based contracts with them are too happy with them.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com