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Wednesday, June 11, 2014

One has to be always wary of doctors because doctors commit fraud


You gotta wonder if this kind of thing is happening at other cancer clinics too.  I wouldn't be surprised at all.  
Gone are the days when doctors were Doctors.  Now, those degrees and diplomas are to do with status and making money any which way.  

From Kentucky Attorney's Office:
...Elizabethtown Hematology Oncology, PLC, and its owners have agreed to pay $3,739,325.41 to resolve allegations that they submitted or caused to be submitted false claims for payment to the Medicare, Medicaid, TRICARE – the health care program for Uniformed Service members, retirees and their families worldwide – and the Federal Employee Health Benefit Program (FEHBP) for extending the duration of chemotherapy infusion treatment to patients and inappropriately billing office visits for infusion therapy treatments, announced the Office of Inspector General of the Department of Health and Human Services and David J. Hale, United States Attorney for the Western District of Kentucky.

"Manipulating treatment protocols and lengthening infusion times to increase reimbursement reflect an extraordinary lack of regard for patient welfare and the integrity of our health care system. This settlement will end these unacceptable practices and restore funds paid for improper claims during the relevant time period,” stated David J. Hale, United States Attorney for the Western District of Kentucky. “Pursuing health care fraud is a priority of my Office and the Department of Justice. We will continue to work with the Department of Health and Human Services to pursue medical providers who engage in improper conduct and overbill government health care programs."..........

.........According to the settlement agreement, the United States and Commonwealth of Kentucky contend that Dr. Rafiq Ur Rahman and Dr. Yusuf K. Deshmukh, owners of Elizabethtown Hematology Oncology, PLC (EHO), billed Medicare, TRICARE, FEHBP and Medicaid from January 1, 2005, through December 31, 2010, for unnecessary office visit evaluations at the same time patients were receiving chemotherapy or other types of infusion treatments. The United States and Commonwealth of Kentucky contend that EHO did this by improperly billing evaluation and management codes using Modifier-25 (allows for billing evaluation and management necessary prior to the performance of a procedure).

The United States and Commonwealth of Kentucky further contend that during a seven year period, between January 1, 2006 and December 31, 2012, Dr. Rahman, Dr. Deshmukh, and EHO unnecessarily and improperly extended the duration of chemotherapy infusion treatment times for their patients in order to improperly bill Medicare, TRICARE, FEHBP and Medicaid for those additional hours of chemotherapy infusion treatments.......

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