Part B Insider (Multispecialty) Coding Alert

Published on Sun Jun 04, 2006 PDF

Radiologist Robert Riether and his wife Judith could face a stiff prison sentence for fraudulent medical billing . The U.S. Attorney for the Northern District of Ohio said a federal grand jury had returned a 13-count indictment that said the Riethers billed Medicare more than $6 million, and were paid $3.7 million, for non-covered services.

The Riethers allegedly billed Medicare as if Robert Riether had performed modified barium swallow (MBS) tests in his office in Massillon, OH. In fact, he was employed full-time in another town and eventually moved to New Mexico during that time period. Instead, the Riethers allegedly paid a contract doctor, a speech therapist and a driver to travel to nursing homes and administer the tests. Medicare won’t pay for MBS tests performed in nursing homes.

Prosecutors say Riethers also billed for spot X-rays and other services that weren’t ordered by any physician.