tci Medicare Compliance & Reimbursement - 2015 Issue 11

Industry Notes: House Calls Pay Far Too Much In This Case

House calls can pay — but they can also raise red flags if you’re billing them excessively. That’s what one Texas physician discovered recently, when the Department of Justice (DOJ) charged him with health care fraud. The doctor and his employee were arrested on May 8 for their suspected roles in a scheme that cost the government over $5 million. The DOJ alleged that the doctor billed home visits as if he personally performed them, but actually sent his employee (a non-physician) to do them and was not present when the visits took place. In addition, some...

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