Medicare Compliance & Reimbursement

Noted physician sentenced in dialysis billing probe.  A 7-year-old entry in a dialysis patient's medical chart has saddled a highly regarded nephrologist with a $100,000 restitution order. In addition to the restitution, U.S. District Court Judge Robert Lasnik Sept. 25 sentenced Dr. William Couser to five years' probation and 1,000 hours of community service in connection with a health care fraud investigation. The sentence comes on the heels of Couser's March 26 guilty plea to a single count of making a false entry on a patient's chart in 1996. According to U.S. Attorney John McKay, Couser indicated that he was present during the patient's dialysis treatment - a requirement when billing for a physician's professional services relating to dialysis - when in fact he wasn't there. Specifically, Couser wrote "Dialysis in progress. No acute problems. Patient seen and examined." As part of the plea agreement, Couser - a professor at the University of Washington's School of Medicine - admitted to writing similarly fraudulent notes for other patients between 1991 and 2002. Couser is the past president of the American Society of Nephrology, the vice president of the International Society of Nephrology and editor-in-chief of the Journal of the American Society of Nephrology. Until last February, he also headed UW's nephrology department. Lesson Learned: The feds are still prosecuting cases relating to physician presence rules in teaching hospitals - one of the oldest compliance hot-buttons around.