HomeCompliance Update → Incident-to Billing Investigation Ends in $118,000 Fine

Incident-to Billing Investigation Ends in $118,000 Fine Print E-mail
Written by Vitale Health Law   
Thursday, 30 May 2019 00:00

A physician in Texarkana, Texas recently agreed to pay $118,000 to settle allegations he engaged in improper billing practices for his Medicare patients at three of his clinics. According to the allegations, Dr. Donald S. Douglas' advanced practice nurses (APNs) were hired to assist him with seeing patients in his clinics. By law, if the services are provided with proper physician supervision, they may be billed to Medicare at the full physician rate. Without direct supervision, APNs may bill Medicare, under their own national provider identifiers (NPIs) at a reduced rate. It was alleged that Dr. Douglas billed Medicare for services provided by his APNs at the full physician rate, even when a physician was not available to supervise the APNs' services.

Last Updated on Friday, 31 May 2019 11:01

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