Part B Insider (Multispecialty) Coding Alert

Published on Wed Jun 08, 2011 PDF

Plus: Medicare now covers Provenge® for prostate cancer patients.

Medicare wants physicians' signatures on their charts--but only if they're signing off on work they actually performed. A Florida physician faces up to 10 years in prison after pleading guilty to healthcare fraud this week, during which he was accused of signing evaluations, notes, and other documents for patients who did not require the treatments given and documented.

The physician was a psychiatrist who knew that many of the patients attending the partial hospitalization program where he worked did not require intensive mental health treatments, but signed files without examining patients and wrote prescriptions for psychiatric medications that the patients did not need so it would appear that they qualified for the treatments being billed.

The facility is alleged to have committed over $200 million in Medicare fraud, and the physician personally had a role in $19.3 million of that sum in fraudulent Medicare billing.

To read more about the case, visit www.justice.gov/opa/pr/2011/June/11-crm-871.html.