tci Medicare Compliance & Reimbursement - 2014 Issue 24

Industry Notes: 'No Show' Physician Faces 5 Years in Prison Over $13 Million Scheme

A Brooklyn, NY healthcare clinic was raking in cash over the past several years, despite the fact that investigators say its medical director wasn’t even on site to perform the services being billed to Medicare and Medicaid. The doctor pleaded guilty last week to his role in submitting over $13 million in fraudulent claims to government insurance plans between 2009 and 2012. Although the physician wasn’t at the clinic, the facility billed the services to Medicare and Medicaid under his provider number since he was the medical director, the Department of Justice (DOJ) said in a Dec...

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