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Fraud Prevention & Detection / Enforcement Actions / Criminal Actions

February 2005
 
 

Physicians and Other Health Care Professionals

Employee Misconduct

Physicians and Other Health Care Professionals

 

 

February 2005

 

 

In Florida, two chiropractors were each sentenced to six months home detention, ordered to pay a $10,000 fine and pay $400,000 in joint and several restitution for their involvement in a variety of fraud schemes. Among other things, the chiropractors were involved in an illegal kickback arrangement with a diagnostic company, billed Medicare using a physicians’ Medicare number without his knowledge or consent, utilized unlicensed and unsupervised personnel to perform procedures, billed chiropractic services as physical therapy, and routinely upcoded services.

 

Employee Misconduct

 

 

February 2005

 

 

In South Dakota, a former Indian Health Service (IHS) employee was sentenced to 200 hours of community service and ordered to pay a $6,000 fine for false statements involving Federal health care programs. The woman was a medical records technician at an IHS hospital. Investigation revealed that during a two-year period, in order to save time and avoid workload backlogs, the woman entered the same diagnosis code for patients seen in the emergency room regardless of their medical condition.

 
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