|February 20, 2012|
Previously published on February 16, 2012
The Office of Inspector General recently issued an alert encouraging physicians to be wary of any entities to which they reassign their right to Medicare payments through a CMS-855R form in light of the fact that the physicians may be liable for any false claims that are submitted by the entity. In addition to using heightened scrutiny of entities to be sure that they are legitimate providers or suppliers before reassigning their Medicare payments, physicians should monitor the services for which the entity actually submits claims using the physician’s reassigned provider number. The OIG’s alert may be found at: http://oig.hhs.gov/compliance/alerts/guidance/20120208.asp
The OIG Alert, issued on February 8, 2012, came after the OIG reached settlements with eight physicians who had reassigned their Medicare payments to physical medicine companies in exchange for Medical Directorship positions. Bills were submitted by the companies that falsely claimed the physicians performed the services. Many of the owners and operators of the physical medicine companies were criminally prosecuted. However, the OIG also determined that the physicians violated the Civil Monetary Penalties Law by causing the physical medicine companies to submit false claims to Medicare. The physicians failed to monitor the services billed and the OIG found that the physicians were an integral part of that scheme, and thus pursued their liability, despite the fact that they had reassigned their Medicare provider numbers.
The OIG also noted that a physician has the right to unrestricted access to the claims submitted by an entity using the physician’s reassigned provider number. According to the OIG, such access is meant to provide added assurances that the services for which the entity billed Medicare were, in fact, performed as billed.