Paul Fallon and Portsmouth Associates
Outcome
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Details
Paul Fallon and Portsmouth Associates — $112,000 Fine
Outcome: Official websites use .gov A .gov website belongs to an official government organization in the United States.
Official websites use .gov A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
After they self-disclosed conduct to OIG, Paul Fallon, M.D. and Portsmouth Psychiatrics Associates (collectively, "Portsmouth"), New Hampshire, agreed to pay $112,533.43 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Portsmouth submitted claims to Medicare for services rendered by an unlicensed provider, as "incident to" when the "incident to" requirements under Medicare were not met.
HHS Office of Inspector General
How Crucible Prevents This
Crucible's compliance monitoring controls for Behavioral Health / SUD Treatment would have detected the patterns underlying this violation through automated screening, documentation enforcement, and real-time alert escalation.
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