Part B Insider (Multispecialty) Coding Alert

Published on Fri Feb 03, 2012 PDF

Plus: Follow these pointers when billing for TENS.

Are you referring a vast number of patients to the same rehab facility every time? The OIG may want to talk to you.

Nine healthcare professionals, including four physicians and one physician's assistant, were charged last week with conspiracy to violate the Anti-Kickback Statute after they were accused of accepting cash for referrals to a Michigan-based group of medical clinics, rehab facilities, and home health companies.

The owner of the facilities is alleged to have paid the healthcare providers for referring patients for electrodiagnostic testing, physical therapy, and home healthcare services. The rehab provider disguised the kickbacks as reimbursement for non-existent expenses, such as mileage, continuing medical education, and medical director fees, according to a Jan. 24 Department of Justice press release.

"Patients deserve to know that when a doctor refers them for additional treatment, the decision to do so is based upon quality health advice--not what is best for the doctor's bank account," said Michigan Attorney General Bill Schuette in a statement.

The healthcare workers face up to five years in prison and a $250,000 fine. To read the government's press release about the case, visit www.fbi.gov/detroit/press-releases/2012/nine-health-care-professionals-including-five-doctors-charged-in-kickback-scheme.