Medicare Compliance & Reimbursement

Incident-to billing and POS still under OIG's microscope.

Three physicians agreed to repay $1 million after they allegedly billed for services that nurse practitioners and physician assistants provided. The physicians billed for the services as though they provided them personally.

Also, a Pennsylvania cardiologist repaid $435,000 after the government claimed he was billing consults that didn't meet the definition of a consult, or lacked proper documentation. The feds also claimed he billed for evaluation & management services that were already covered in his payment for nuclear stress testing.

Beware: Those are just two of the horror stories in the latest semiannual report from the HHS Office of Inspector General (OIG). The OIG is still looking over your shoulder on incident-to billing, consults and incorrect place of service (POS).

Just ask the Ohio pain management physician who received a life prison sentence, plus $14.3 million repayment, after a jury found he performed unnecessary " and painful " procedures on patients, in exchange for narcotic prescriptions.

Or the Florida physician who earned 70 years' exclusion from Medicare after she prescribed unnecessary drugs and one patient died of an overdose.