Eli's Rehab Report

Published on Tue Feb 20, 2007 PDF

Your physical therapy billing could be a major hot button in the new year, judging from the HHS Office of Inspector General's semi-annual report on fraud and abuse. 

A Texas physician received an 11-year, three-month sentence for taking part in schemes to defraud Medicare, the OIG says. He accepted money from clinic owners in exchange for signing charts for physical therapy, helping the clinic owners to submit false claims. In another scheme, the doctor ordered motorized wheelchairs for patients whom a company transported to his office and performed unnecessary medical services for those patients.
 
The number of physicians billing more than $1 million for physical therapy per year more than doubled from 2002 to 2004, the OIG found in a recent study. Claims for physical therapy increased from $353 million to $509 million during that period, and the OIG found "significant and persistent compliance and quality-of-care problems." 

Another conviction the OIG noted: A California audiologist allegedly billed Medicare and Medi-Cal for hearing aids, speech-language pathology and related services without a license. She also allegedly billed for services provided to dead patients. She received a 78-month sentence and must repay $868,000.