Part B Insider (Multispecialty) Coding Alert

Published on Fri Jan 01, 2010 PDF

Plus: CMS debuts new Medicare tool that helps you spell out confusing terms, enrollment information, and payment rules.

The Medicare Strike Force has struck again, this time focusing on a Michigan-based physical therapist who pled guilty to conspiracy to commit health care fraud. The therapist faces a maximum sentence of 10 years in prison and a $250,000 fine for creating fictitious therapy files in which she documented physical and occupational therapy services to Medicare patients, even though she hadn't actually delivered the therapy.

In total, the therapist collected over $127,000 for creating the false documentation, which allowed the home health agency that employed  her to collect about $2.375 millionfrom Medicare, according to a Jan.

25 Dept. of Justice news release. To read the Dept. of Justice news release, visit www.justice.gov/opa/pr/2010/January/10-crm-083.html.