Medicare Compliance & Reimbursement

PA billing at a physician's rate facing a half-century in the big house.

Submitting outpatient services claims to Medicare and Medicaid for patients who were hospitalized on the service dates will result in health care fraud charges.
 
A federal grand jury indicted Larry J. Solomon, a physician's assistant and manager of BPS Medical and Rehabilitation, PLLC and Diversified Medical and Associates in Washington, D.C., on health care fraud, false statements in regard to health care and money laundering charges, according to a May 26 Department of Justice press release.
 
From May 1999 to March 2005, Solomon allegedly submitted Medicare and Medicaid claims for services on dates when no BPS employee provided services and claims using codes for more lengthy and costly services than the services actually provided, the DOJ says.
 
Solomon purportedly billed outpatient services to Medicare and Medicaid for deceased or hospitalized patients. He also charged Medicare a physician's rate even though Solomon or another PA provided the services, the DOJ alleges. Solomon allegedly laundered the Medicare and Medicaid revenues from BPS through his various incorporated companies' bank accounts.
 
Punishment: If convicted on all counts, Solomon faces more than 50 years imprisonment.
 
To read the press release, go to http://www.usdoj.gov/usao/dc/Press_Releases/2005_Archives/May_2005/05169.htm.
 
Lesson Learned: Billing fraudulent Medicare and Medicaid claims and laundering money can result in a lengthy prison sentence.