Part B Insider (Multispecialty) Coding Alert

Published on Fri Aug 13, 2010 PDF

Plus: Don't forget ZPICs when it comes to your compliance program.

Clinics billing Medicare for millions of dollars worth of services -- but without any legitimate services -- always get caught eventually.

Case in point: A Michigan-based clinic was recently nailed by the Dept. of Justice, which accused the clinic of billing Medicare for $2.3 million in fraudulent charges. The clinic's owner was married to a physician who falsified patient records by documenting fictitious symptoms that could justify expensive and exotic medications, according to a DOJ news release on the topic.

The patients that visited the clinic were not referred by other physicians for legitimate reasons, but were "recruited" via kickbacks from the clinic owners.

To read more about this case, visit www.stopmedicarefraud.gov/HEATnews/dc.html#aug-27-2010