tci Medicare Compliance & Reimbursement - 2015 Issue 20

Industry Notes: Medical Biller Lands in Prison for Her Role in Fraud Scheme

If you thought the government only went after medical practitioners for fraud, think again. On Sept. 18, the Department of Justice (DOJ) announced that a Chicago medical biller faces 45 months in prison after being convicted of health care fraud. The biller “routinely billed Medicare for overseeing patient care plans (a service known as ‘care plan oversight’) when, in fact, the doctors at the organization rarely provided the service,” the DOJ said in a news release. She also billed Medicare for services rendered to deceased patients and even coded using the ID numbers of practitioners...

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