tci Part B Insider - 2015 Issue 22

Physician Notes: Physician Pays $105,000 to Settle Accusations That Staff Performed E/M Services

A doctor in Oklahoma is in hot water after the government accused him of letting unlicensed staff members to perform not only the patient history section of his E/M visits, but also the physical examination and medical decision-making portions as well—and then sending the bills to Medicare as if he performed the services himself. “Medicare regulations require that such services must be provided by a licensed physician or nurse practitioner to qualify for payment,” the Department of Justice said in a June 11 press release about the case. The physician is subject to financial penalties for...

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