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OIG posts alert on added charges for covered services

Compliance Monitor, April 7, 2004

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The OIG posted March 31 an alert for physicians about added charges for covered services. In the document, Acting Principal Deputy Inspector General Dara Corrigan reminds Medicare participating physicians of the potential liabilities posed by billing Medicare patients for services that are already covered by Medicare.

When providers request any other payment for covered services from Medicare patients, they are liable for substantial penalties and exclusion from Medicare and other federal healthcare programs.

The OIG offers an example: It recently alleged that a physician violated his assignment agreement when he presented to his patients-including Medicare beneficiaries-a "personal healthcare medical care contract" asking patients to pay an annual fee of $600. Services specified included the "coordination of care with other providers," "a comprehensive assessment and plan for optimum health," and "extra time" spent on patient care.

While the physician claimed the services were not covered, the OIG alleged that at least some of these services were already covered and reimbursable by Medicare.

The OIG concluded that each contract presented to the physician's Medicare patients constituted a request for payment for already covered services, and was a violation of the physician's assignment agreement.

To read the alert, click here.

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