tci Medicare Compliance & Reimbursement - 2003 Issue 17

Physicians: FRAUD HUNT SPOOKS DOCS INTO DOWNCODING

Haunted by late-night worries about being targeted in a Medicare fraud investigation? If you're a physician, you're not alone. A recent study sponsored by the Medicare Payment Advisory Commission reveals that about a quarter of physicians are "extremely concerned" about fraud and abuse investigations, and another 45.6 percent are "very concerned" or "concerned." That's having an impact on physicians' bottom line, suggests the study, which was conducted by the Project HOPE Center for Health Affairs. More than two thirds of all physicians have billed "more conservatively than they felt was warranted in order to minimize the possibility...

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