OIG Issues Alert Warning Physicians that They Can Be Liable for False Claims Submitted by Entities to Which They Have Reassigned Their Medicare Billing Rights


On February 8, 2012, the Office of Inspector General (OIG) issued an OIG Alert warning physicians to exercise caution when reassigning their right to bill the Medicare program.  According to the Alert, “[p]hysicians who reassign their right to bill the Medicare program and receive Medicare payments by executing the CMS-855-R application may be liable for false claims submitted by entities to which they reassigned their Medicare benefits.”  The OIG indicated that it had recently reached settlements with eight physicians who had allegedly violated the civil monetary penalty law by causing the submission of false claims for claims submitted to Medicare by physical medicine companies to which the physicians had reassigned their Medicare billing rights in exchange for medical directorship positions.  According to the OIG, the physical medicine companies billed Medicare for services that were not actually performed or performed as billed.  The physical medicine companies, using the physicians' reassigned billing numbers, falsely certified to Medicare that services performed by unlicensed physical therapy technicians had been performed or directly supervised by the physicians, when such was not the case. 

The Alert states that physicians have an obligation to monitor billing and other records to ensure that claims using their reassigned provider numbers are billed correctly.  The OIG noted that physicians who reassign their billing rights to an entity have a right to access the entity’s billing and claim information for the services that the physicians are alleged to have performed.  

Please see full alert below for more information.

LOADING PDF: If there are any problems, click here to download the file.

Written by:

Published In:

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© King & Spalding | Attorney Advertising

Don't miss a thing! Build a custom news brief:

Read fresh new writing on compliance, cybersecurity, Dodd-Frank, whistleblowers, social media, hiring & firing, patent reform, the NLRB, Obamacare, the SEC…

…or whatever matters the most to you. Follow authors, firms, and topics on JD Supra.

Create your news brief now - it's free and easy »

All the intelligence you need, in one easy email:

Great! Your first step to building an email digest of JD Supra authors and topics. Log in with LinkedIn so we can start sending your digest...

Sign up for your custom alerts now, using LinkedIn ›

* With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name.