Part B Insider (Multispecialty) Coding Alert
Physician Pays $105,000 to Settle Accusations That Staff Performed E/M Services
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A doctor in Oklahoma is in hot water after the government accused him of letting unlicensed staff members to perform not only the patient history section of his E/M visits, but also the physical examination and medical decision-making portions as well—and then sending the bills to Medicare as if he performed the services himself.
“Medicare regulations require that such services must be provided by a licensed physician or nurse practitioner to qualify for payment,” the Department of Justice said in a June 11 press release about the case.
The physician is subject to financial penalties for each False Claims Act infraction, and agreed to pay $105,000 in civil penalties to settle allegations. The whistleblower who brought the case to the government’s attention will collect $28,350.
Resource: To read more about the case, visit www.justice.gov/usao/okn/news/2015/blocksettlement0611.html.
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Physician Pays $105,000 to Settle Accusations That Staff Performed E/M Services
A doctor in Oklahoma is in hot water after the government accused him of letting [...]