29 Jul HOW SHOULD THE PARTNERS HANDLE THE SITUATION WITH THE OTHER PHYSICIAN PARTNER?
One member of the office staff has asked whether Medicare would consider this behavior “fraudulent.”How should the partners handle the situation with the other physician partner?
The partners in a medical group practice are informed by the clinic manager that one physician member of the group has been repeatedly upcoding procedures for a specific diagnosis. This issue first came to light six months ago. At that time the partners met with him, clarified the Medicare guidelines, and outlined the threat to the practice for noncompliance. He argued with their view, but ultimately agreed to code appropriately. There were no infractions for several months, but now he has submitted several erroneous codes. One member of the office staff has asked whether Medicare would consider this behavior “fraudulent.”How should the partners handle the situation with the other physician partner?
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