After many years counseling physicians regarding Medicare fraud and abuse compliance, I’m still perplexed at the general lack of understanding in the physician community regarding the need to comply with complex healthcare fraud and abuse laws and the serious risks of noncompliance. Unfortunately, it seems that many physicians still mistakenly believe that they are “below the radar” when it comes to compliance.
As evidence that even individual physicians can be held to account for improper conduct, Modern Healthcare reports this week about an Ohio cardiologist who has been sentenced to 20 years in prison for overbilling. Of course, the vast majority of physicians do not engage in intentional fraudulent or abusive billing but even relatively simple billing mistakes can result in large overpayments or expensive and disruptive investigations. For this reason, having an effective compliance program in your medical practice is critical to avoiding costly compliance mistakes.