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OIG Alerts Physicians to Exercise Caution When Reassigning Medicare Payments

February 16, 2012

On February 8, 2012, the Office of Inspector General (OIG) released an alert advising physicians to exercise caution when reassigning their Medicare payments.  Under Medicare rules, a physician may reassign his or her right to bill the Medicare Program and receive payments to another eligible entity, including individuals, clinics or group practices, and other organizations, by filing a CMS-855R application.  The OIG warns that physicians who reassign their Medicare payments may be held liable for false claims submitted by the entities to which they reassigned their benefits.  Accordingly, physicians are encouraged to use “heightened scrutiny” prior to reassigning their Medicare payments to another entity.

In the alert, the OIG details recent settlements with eight physicians who had reassigned their Medicare payments to several physical medicine companies in exchange for medical directorship appointments.  Although the physicians did not render or directly supervise any services, the claims that were subsequently submitted to Medicare for payments under their reassigned provider numbers were performed by unlicensed, unqualified “technicians.”  As a result, many of the owners and operators of the companies were criminally prosecuted and civil monetary penalties were imposed on the physicians involved.

Importantly, the OIG reminds physicians that if they do decide to reassign their Medicare payments to another eligible entity, they have a right to access that entity’s billing information relating to the services the physician is alleged to have performed and for which the entity has billed Medicare.  Physicians may want to consider making it their practice to review the claims for which an entity bills Medicare using their provider numbers in order to ensure that services were indeed performed as billed.  This way, physicians will be able to avoid potential liability.

If you have any questions about the OIG alert or the reassignment of Medicare payments, please contact any of the members of the Shipman & Goodwin Health Law Practice Group.


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