tci Part B Insider - 2016 Issue 2

Physician Notes: Doctor to Repay Government $3.75 Million for Unnecessary Tests

Plus: ACOs will treat 9 million people, thanks to addition of new organizations. A Virginia physician is in hot water after allegedly billing Medicare and Medicaid for cancer detection tests that were medically unnecessary, and offering inducements to other practitioners in exchange for referrals to his laboratory. The doctor in question owned a pathology lab which billed Medicare and Medicaid “for expensive cancer detection tests known as Fluorescent In Situ Hybridization (FISH) tests, as well as other tests, that were not medically necessary and were performed without the treating physicians’ consent or order,” according to a Jan...

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