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Medicare Compliance & Reimbursement

Physician Notes:

Physician's Assistant Accused of Ordering Unnecessary Tests That Clinic Fraudulently Billed to Medicare

Published on Sun Aug 08, 2010

Clinic used "Cappers" to fraudulently bill Medicare The Dept. of Justice not only caught a practice with its hand in the till -- it found the practice stuffing the till with Medicare dollars. On July 22, the DOJ announced that it unsealed a 17-count indictment against four employees of a medical clinic in San Diego. The clinic's founders are accused of hiring "cappers" to bring in Medicare beneficiaries to the clinic so they could submit false claims to Medicare for the services. Another clinic employee, a physician's assistant (PA), allegedly ordered medically unnecessary tests and procedures that were later billed to Medicare. In addition, the PA is accused of "falsely holding himself out as a medical doctor to individuals at the clinic," according to the DOJ press release. (Editor's note: To read more about this case, visit www.justice.gov/usao/cas/press/cas10-0722-Kagramanian.pdf.)
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