Health Care News & Discussion
How Medicare Special Agents are Going After Doctors
01/04/1999 2:07 PM
Medicare has hired 400 ex-FBI agents. What could Medicare do with 400 ex-FBI agents, you’re probably wondering. Stage an agent Olympics? Make a James Bond epic? No–Have them chase after doctors!
Medicare has placed these agents in all major cities in the United States, has given them $400 million dollars, badges and guns, and given them the mission of retrieving the money doctors have quote unquote stolen.
These agents have already begun auditing patient charts, looking for fraud. All chart notes must be legible to an agent without any explanation from staff. All labs and correspondence must be initialed and dated before being placed in the chart. Diagnosis coding must reflect absolute accountability to chart notes. An agent needs only to find a mistake; the agent does not have to prove the physician intended fraud. These are all ten thousand dollar fines per occurrence. And these penalties extend to the administrative staff as well as the physicians. The bottom line is that a physician’s reporting of services must match the documentation.
Documentation is not subjective with Medicare. It is strictly color by numbers/stick to the rules/black and white objective. It’s either right or it’s wrong, and if it’s wrong, Medicare intends to raid your coffers. The new guidelines released for implementation beginning January 1, 1998, must be followed to the T.