tci Medicare Compliance & Reimbursement - 2016 Issue 21

Industry Note: DOJ Gives a Hefty Sentence to a Michigan Physician with a Trifecta of Fraud Charges

Most offenders of Medicare fraud fall into categories of severity, which render the perpetrators guilty of either civil or criminal actions. It is a rare circumstance when a physician breaks laws across states, both civilly and criminally, losing medical credentials in the process. A Michigan physician was found guilty of falsifying documentation, improperly billing payments under the False Claims Act, and violating the “federal Controlled Substances Act in his treatment of patients for pain and substance use disorders by prescribing patients a combination of at least one opioid, one benzodiazepine, and carisoprodol (a combination colloquially referred to as...

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