The OIG recently issued an “Alert” reminding physicians that they may be liable for false claims submitted by entities to which they reassign their right to bill the Medicare program. The OIG raises this issue following a recent settlement it concluded with eight physicians who violated the Civil Monetary Penalties Law by causing the submission of false claims to Medicare from an entity to which they had reassigned benefits. The failure of these eight physicians to monitor the services billed under their reassigned billing numbers resulted in the submission of “false bills” to Medicare. The OIG expects physicians to monitor the services billed under their reassigned billing numbers regardless of who is actually billing. The OIG noted that physicians have a right to unrestricted access to claims submitted by an entity for services that the entity billed using the physicians’ reassigned billing number. In this “Alert” the OIG encourages physicians to exercise this right in order to ensure that the services for which the entity billed Medicare were, in fact, performed and were performed as billed.
The Medicare program prohibits the reassignment of claims by physicians except under certain circumstances. The exceptions to the rule against assignment include payment to an employer and payment to an entity under a contractual arrangement, such as a professional services agreement. The Medicare program has long provided for joint and several liability for Medicare overpayments when a physician reassigns his or her right to bill the Medicare program under a contractual arrangement. This “Alert” brings attention to the far greater risk of liability that may be imposed under the federal False Claims Act. Physicians who reassign their right to bill should carefully consider what safeguards are in place to ensure that the billing entity is properly submitting claims to the federal health care programs.