tci Part B Insider - 2003 Issue 20

Upcoding Leads to Boring Weekends - Prosecutors Treat Coding Violations Like Hard-Core Crimes

Enforcers of healthcare-fraud laws are using the latest trends in criminal sentencing to lay down the law on coding issues. New York Attorney General Eliot Spitzer says that Bath, N.Y., physician Dr. Ashar Tahir, after pleading guilty to fraud charges July 23, agreed to a sentence of six months "shock probation," community service and five years probation. Shock probation means Tahir will be incarcerated during the weekends, and spend weekdays under electronic home monitoring. According to prosecutors, Tahir submitted bogus reimbursement claims to Medicare, Medicaid and another payer in which he overstated the extent of the services...

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