tci Medicare Compliance & Reimbursement - 2017 Issue 18

Compliance: Medicare Biller Gets Jail Time and Millions in Fines for Fraudulent Claims

Hint: You thought billers couldn’t be held responsible? Think again. Billers and coders know that Medicare providers are responsible for the codes that they report to CMS — but that doesn’t absolve the billing staff of fraud accusations, or prison sentences. That’s the word from a recent case involving a medical biller in Michigan who headed to prison for a 50-month sentence earlier this summer. Verdict: Medical biller Dawn Bentley was sentenced to 50 months behind bars for her part in a $7.3 million fraud scheme that involved billing services to Medicaid and Medicare, even...

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