BRETT L HAMPTON, LMSW

NPI 1053683904, individual, Idaho Falls, ID, Social Worker

Evidence tier

informational

Medicaid dollars per patient on code H0005 ($580 per patient-month) sit in the top 5% of every provider billing that code.

score 35 of 100, rank 9925, $2.9M at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	BRETT L HAMPTON, LMSW
Type	Individual, sole proprietor
Status	Active
NPI issued	February 7, 2012, last updated February 7, 2012
Practice location	1970 E 17TH ST STE 202, Idaho Falls, ID 83404-8048, 208-523-5319
Specialties	Social Worker (104100000X, primary, license LMSW-28497 ID)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
H2017	Psychosocial rehabilitation services per 15 minhistory of abuse	$2.1M	36%	$450	$310 (top 5% from $1K)	67th percentile
T1017	Targeted case management each 15 min	$1.1M	19%	$193	$167 (top 5% from $808)	54th percentile
H0038	Self-help/peer services per 15 min	$1.0M	18%	$340	$147 (top 5% from $2K)	74th percentile
90834	Psychotherapy, 45 minutes	$545K	9%	$147	$101 (top 5% from $318)	71st percentile
H0005	Medicaid service code	$204K	4%	$580	$129 (top 5% from $479)	97th percentile
T1016	Case management each 15 min	$126K	2%	$179	$98 (top 5% from $507)	70th percentile
H0046	Medicaid service code	$124K	2%	$155	$60 (top 5% from $2K)	62nd percentile
S9485	Crisis intervention mental health services per diem	$116K	2%	$741	$749 (top 5% from $2K)	too few months to rank

In this area

5 providers in Bonneville County, ID carry an indicator in the public record, with $7.2M at stake between them. The most common is part of a provider network, on 3 of them, followed by more hours than a day holds on 2.

tier	provider	at stake	why
3	EDEN HOME HEALTH OF IDAHO FALLS, LLC Idaho Falls, ID, ranked 2356	$0	Part of provider network D1-00079, ranked 79 nationally.
3	EDEN HOSPICE AT IDAHO FALLS, LLC Idaho Falls, ID, ranked 4976	$0	Part of provider network D1-00079, ranked 79 nationally.
3	OAKSTONE HOSPICE LLC Idaho Falls, ID, ranked 5393	$0	Part of provider network D1-00098, ranked 98 nationally.
4	THOMAS TUELLER Idaho Falls, ID, ranked 8394	$5.3M	Hours beyond a day in 7 months, but with up to 1005 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed.
5	STEVEN ORME Idaho Falls, ID, ranked 9978	$1.9M	Medicaid dollars per patient on code H0005 ($908 per patient-month) sit in the top 5% of every provider billing that code.

Recent enforcement in ID

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementOct 29, 2024

Boise Health Care Company and Former Therapist Resolve Fraudulent Psychotherapy Billing Allegations Involving Vulnerable Refugee Population

KA Health Services and its owner paid $321,576.51 to resolve allegations they submitted false Medicaid claims for psychotherapy, language interpretation, and other services that were never provided or not provided by a qualified professional, and a former counselor consented to a $40,000 judgment after admitting she directed unqualified interpreters to meet with refugee clients and signed false medical records.

DOJCivil settlementApr 3, 2024

Pocatello Doctor Pays $96,000 to Settle Allegations That He Wrote Unlawful Prescriptions

The government alleged that Knouf wrote prescriptions for controlled substances that lacked a legitimate medical purpose and/or were issued outside the usual course of professional practice, prescribed dangerous combinations of drugs, and billed Medicare and Medicaid for services that were not performed.

DOJCivil judgmentJan 17, 2024

AmeriHealth Clinics Consent to a $2 Million Judgment to Resolve Healthcare Fraud Allegations

AmeriHealth and its owners hired vulnerable, compromised, and inexperienced medical staff who were pressured into providing unnecessary and worthless care, resulting in false claims to federal health care programs, and also allegedly pressured practitioners to prescribe controlled substances, entered a kickback scheme with a third-party laboratory, and falsely certified information to obtain PPP loan forgiveness.

Referral packet

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