This week in the NY Times it was reported that a directive from the Obama administration, that took effect January 15th, 2014 will start cracking down on MDs who repeatedly overcharge Medicare patients. Additionally, for the first time in 30 years the government may disclose how much is paid to individual MDs treating Medicare patients. There was a stern warning that “recalcitrant” providers could face civil fines and expulsion from the program.
A new section of the Medicare manual encourages the use of fines to penalize MDs who generate a pattern of claims for goods and services that they know or should know are not medically necessary. Providers can also be barred from Medicare if they bill the program for “excessive charges” or for services substantially in excess of patient’s needs.
Although efforts may currently be directly at MDs, experience tells us that investigations into therapy practice billing will not be far behind. For the full article: https://www.nytimes.com/2014/01/26/us/doctors-abusing-medicare-to-face-fines.html?_r=0