Exercise Caution When Reassigning Your Medicare Payments

Physicians who reassign their right to bill the Medicare program and receive Medicare payments by executing the CMS-855R application may be liable for false claims submitted by entities to which they reassigned their Medicare benefits, warns the Office of Inspector General (OIG).

In an alert issued Feb. 8, 2012, OIG encourages physicians to carefully scrutinize an entity before reassigning their Medicare payments, making sure the entity, such as an in-home physical therapy service, is a legitimate provider or supplier of health care items and services. You should ascertain if the company hires certified coders and has procedures in place to minimize the risk of fraud or billing errors.

Physicians also may be able to monitor claims the entity files for the Medicare services they perform. According to OIG, physicians who reassign to any entity their right to bill the Medicare program and receive Medicare payments have the right to access the entity’s billing information concerning the services the physician is alleged to have performed and for which the entity billed Medicare. Physicians have unrestricted access to claims the entity submits for services it billed using the physicians’ reassigned provider numbers, OIG says.

In practice, physicians employed by a system to which they have assigned their Medicare benefits often are denied the right to see any financial documents of the system. If you experience this, it may be that you waived the right to access to this information in your employment contract. If so, at contract renewal time, you may want consider the addition of language that will secure access to your employer’s financial information regarding your Medicare services.

Further, you may want to consider a provision in the employment contract which makes clear the  employer has agreed to indemnify you, as the employee physician, for any errors in billing not attributable to you. The indemnification obligates the employer to cover you for any loss as a result of the support staff’s administrative errors and can even require the employer to pay for any defense costs.

Published Feb. 28, 2012

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