Medicare Doctors who are attempting to take advantage of the government by chronically overbilling and charging Medicare for unnecessary patient care and equipment are the latest target of the Obama Administration.
Doctors engaged in the Medicare program follow guidelines that cover necessary procedures and the allowable reimbursement fees associated with those services. However, the Medicare system has been bilked of billions of dollars in recent years thanks to medical providers who are filing fraudulent claims.
Marilyn B. Tavenner, head of the Centers for Medicare and Medicaid Services, revealed that the government is “losing patience with habitual offenders” of Medicare overcharges. She said that “recalcitrant providers,” doctors who continue to abuse the program even after they have been warned about changing the inappropriate activity, may now face civil fines. Further, these doctors could be prohibited from accepting Medicare and other federal health program payments, a move that might seriously impact their ability to attract patients.
The Feds said that at least $6 billion of improper Medicare payments are made a year, which tallies to about 10 percent of all fee-in-service Medicare payments. Worse yet, Harvard Professor Malcolm K. Sparrow, a health care fraud expert, believes the actual number may be higher still.
The Medicare manual now includes a section that outlines how fines will be used to punish doctors who should know what is medically required but bill Medicare for excessive unnecessary items. About one-third of almost 300 doctors who received more than $3 million each in yearly Medicare payments are now being investigated for “questionable” billing practices.
If you are aware of a physician who is overbilling Medicare or another federal health care program, you may have a qui tam claim. Find out more about U.S. whistleblower guidelines and how you may be able to be compensated for helping the government uncover fraud. Contact the experienced attorneys at Begelman & Orlow, P. C. about your whistleblower case today at 866-627-7052. We represent clients in New Jersey and throughout the entire United States.