Compliance for Teaching Physicians: How to Avoid Millions in Fines

You’ve seen it in the news, stories like this, “Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that the University of Missouri-Columbia has agreed to pay the United States $2.2 million to settle allegations that it violated the False Claims Act...The United States alleged that certain attending physicians certified that they had reviewed the images associated with interpretative reports prepared by resident physicians when, in fact, they had not reviewed those images.”

Or how about this story, “United States Attorney James L. Santelle of the Eastern District of Wisconsin announced today that the Medical College of Wisconsin, Inc. (MCW) has paid the federal government $840,000 to resolve allegations that it violated the False Claims Act. MCW is alleged to have knowingly billed federal healthcare programs for neurosurgeries involving residents who did not receive the required level of supervision from teaching physicians.”

What it boils down to is that for purpose of payment, E/M services billed by teaching physicians require that the Physician personally document at the minimum that they performed the service or were physically present during the key or critical portions of the service when performed by the resident and the participation of the teaching physician in the management of the patient. When assigning codes to services billed by the teaching physicians, reviewers will combine the documentation of both the resident and the teaching physician. Mistakes could result in your organization owing millions.

Tune into my upcoming webinar, Compliance for Teaching Physicians: What We Should All Know, where I'll cover:

  • Why PATH audits were among the first major compliance enforcement initiatives in healthcare it’s relevance today.
  • How compliance professionals at one teaching institution provide training, audits, and tools for teaching physicians
  • The key attestation statements and documentation processes you must follow to stay compliant

Webinar Details Here >>

Questions or Comments?