Medicare Compliance & Reimbursement
Psychiatrist Must Pay Back $908,000 for False E/M Claims
E/M services are a point of contention for many providers, with an oftentimes complex mix of codes and modifiers required to ensure payment. Most physicians innocently send in duplicates or append the wrong modifier, but an Illinois psychiatrist took E/M billing to the next level.
The physician was recently ordered to pay CMS back over $908,000 for false claims at long-term care facilities in Illinois. The E/M services reported were either not performed or were not at the level they were claimed under, a Department of Justice (DOJ) news release suggests.
In addition to the hefty fine, the physician will have a 10-year suspension from Medicare, Medicaid, and all other federal healthcare payment programs.
For more information about this DOJ case, visit https://www.justice.gov/usao-cdil/pr/springfield-psychiatrist-ordered-pay-908000-civil-settlement.
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Psychiatrist Must Pay Back $908,000 for False E/M Claims
E/M services are a point of contention for many providers, with an oftentimes complex mix [...]
