Part B Insider (Multispecialty) Coding Alert

Published on Tue May 17, 2011 PDF

Plus: Deadline For PECOS Edits Still Up In The Air

Practitioners may be keeping an eye on their patients' data to ensure that no one steals beneficiaries' identities-- but it's also smart to keep your providers' identities secure. One physical therapist learned that the hard way after two Florida residents pleaded guilty last week in a scheme to defraud Medicare.

The fraudsters bought a therapy practice and indicated that they planned to provide physical therapy to Medicare patients. However, they stole the identity of a legitimate PT to submit claims to Medicare. In addition, they stole Medicare data from people that they knew so they could send claims to Medicare on those patients' behalf, to the tune of $757,654, a June 10 Department of Justice press release notes.

After pleading guilty, the fraudsters each face up to 10 years in prison and a $250,000 fine. To read the complete press release, visit www.justice.gov/opa/pr/2011/June/11-crm-763.html.

Tip: Treat your physician data, including birth dates, NPIs, and Social Security Numbers, with the same security settings that you use for your patient data. Use password-protected computers for all Medicare claimsrelated activity, and file all paper documents in a secure area. Plus, you should shred papers that include this information on them before throwing them in the trash.