Medicare Compliance & Reimbursement

Whistleblowers:

WHISTLEBLOWER CFO TARGETS ALLEGED E&M SNAFUS

Here's one more reason to be sure your evaluation and management coding practices are up to snuff: The ex-chief financial officer of a health care management and billing company just scored a victory in a whistleblower suit against his former employer and two physician practices. Medical groups Health Texas Medical Group and Solomon Anthony Clinic, along with management company Primary CareNet of Texas, will pay $1.36 million to settle the qui tam suit, according to the Department of Justice. The three San Antonio, TX organizations are affiliates of Christus Health of Houston Whistleblower Timothy Ohman's lawsuit accused the three of improperly billing Medicare and Medicaid by upcoding evaluation and management services. Lesson Learned: Don't stint on E&M coding compliance, since whistleblowers could be waiting at the top of your own ranks.
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