OIG Excluded Alabama Physician
Effective July 11, 2016, OIG excluded Bobby Merkle, MD, from participation in all Federal health care programs for a period of three years under 42 U.S.C. § 1320c-5 following a referral to the OIG by Kepro, the Beneficiary and Family Centered Care Quality Improvement Organization (QIO). OIG's investigation determined Dr. Merkle violated his obligations to provide services to five Medicare beneficiaries: (1) when, and to the extent, they were medically necessary; (2) of a quality that met professionally recognized standards of care; and (3) supported by the appropriate evidence of medical necessity and quality in a form and fashion and at such time as they were required by the QIO. Dr. Merkle violated his obligations through prescription practices and choices of medications which violated professionally recognized standards of care, through documentation that did not support the proper management of chronic conditions or diseases in the patients, through failure to assess pain or response to treatment in patient with chronic pain, and for failure to document response to treatment or patient progress for pain, edema, or gastrointestinal upset. Senior Counsels Geoffrey Hymans and Kenneth Kraft represented OIG.
- Date:July 11, 2016
- CMP and Affirmative Exclusions