tci Part B Insider - 2015 Issue 10

Physician Notes: Unnecessary Services Lead to $5.3 Million Repayment for NY Doctor

When coding and billing experts continually remind practices to “put medical necessity first,” they aren’t just blowing smoke. Without a medically necessary reason to perform your services, you could be facing jail time. A New York physician is learning that lesson the hard way this week after pleading guilty to billing Medicare for $14.2 million in claims for medically unnecessary treatments, the Department of Justice reported on March 6. The doctor has to pay nearly $5.4 million back to the government, and will face sentencing later this year. The doctor admitted that he and...

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