tci Medicare Compliance & Reimbursement - 2012 Issue 9

Industry Notes:

NJ Doctor Sentenced for Billing 900 Endoscopies on One Patient Wondering whether insurers are actually checking medical necessity for your procedures? One recent case suggests that they are watching carefully. A New Jersey-based otolaryngologist was sentenced last week to two years in prison for defrauding his insurer of over $725,000, an April 9 DOJ press release says. The physician admitted filing false claims for about 900 nasal endoscopies that he purported to have performed on a single patient over several years. The physician continued to file claims for services he said he performed on the patient even after...

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