Part B Insider (Multispecialty) Coding Alert
E/M Upcoding Charge Garners Hefty Settlement for Physician Practice
A recent Department of Justice (DOJ) settlement shows that the feds take overbilling on E/M services claims very seriously. El Paso Ear, Nose & Throat Associates (EPENT) settled its alleged False Claims Act (FCA) violations for purportedly submitting upcoded evaluation and management (E/M) services claims to Medicare and other federal health programs, a DOJ release says. EPENT agreed to pay DOJ $750,000 to settle the FCA violations. “Providers who line their pockets by over-billing for medical care increase medical costs for all of us and drain critical funds from Medicare and other government health programs,” warns U.S. Attorney Ashley C. Hoff in the DOJ release. “We will continue to hold accountable medical professionals who undermine our healthcare system by over-billing for care.”
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