Part B Insider (Multispecialty) Coding Alert

Physician Notes:

One Doctor Indicted in $33 Million Medicare Fraud Charges

Highlighting your documentation can be good—but not if done literally.

Imagine how different your billings would look if an extra $22 million showed up in your account over an eight year period. You would probably be stunned at the windfall—but one practice in California is accused of considering it business as usual, and is now in hot water with the Department of Justice.

The physician allegedly billed Medicare for services that weren’t medically necessary, and sometimes billed for services he never provided at all. He also is said to have signed orders for medications, home health, hospice services, and durable medical equipment that were later sold to other entities so they could likewise create fraudulent billings.

After billing $33.4 million between Jan. 2006 and May 2014, the doctor allegedly collected over $22 million on those allegedly false billings, and the FBI and Department of Justice moved in for the arrest. The doctor was indicted on June 3 and charged with one count of conspiracy to commit health care fraud.

To read more about this case, visit www.justice.gov/opa/pr/2014/June/14-crm-596.html.