Although I’ve been told that the quantum mechanics principle known as quantum superposition suggests that particles can exist in two separate locations at the same time, it tells us nothing about physicians being able to be in two places at once.
That’s odd, because physicians sometime demonstrate that ability, at least on billing records.
On the other hand, in settling civil False Claims Act allegations against her, Anuja Kurichh, M.D., an internal medicine physician and sole practitioner in College Park, Maryland, and her practice, PHC Healthcare, LLC, made no admission of any sort, including, one would suppose, of quantum supposition, when she agreed to pay the United States Government $555,000 to resolve allegations that she violated the federal False Claims Act by submitting claims to Medicare and the Federal Employees Health Benefits Program for procedures and medical management codes indicative of face-to-face patient encounters supposedly lasting for time intervals of ten to fifteen minutes, despite being, per travel records, outside of the United States on the billed dates of service.
According to the government’s allegations, Dr. Kurichh also billed Medicare and the Federal Employees Health Benefits Program for the interpretation of ultrasounds purportedly performed by another physician who did not, in fact, perform those services.
As is always the case in regard to settlements, the claims against Dr. Kurichh and PHC Healthcare are allegations only. The settlement is not an admission of liability by Dr. Kurichh or PHC Healthcare, LLC, nor a concession by the government that its claims are not well founded.
Some Timely Tips For You
1. No matter what quantum physics might suppose, the government will never believe you can be boating in Belize and billing in Boston at the same time.
2. Even though you are too smart and too honest to try to pull off anything of the sort, the other physicians in your group might not be, especially if your compensation plan pays them based on productivity. Claims made by your group as a result of your physicians’ claimed services can get your group into the same civil mess.
3. And, importantly, there need not be any improper intent behind any of your, or your group’s physicians’, billings–a simple mistake, that is, negligence, will get you to the same spot.
4. For individuals, the recommended course of action is the same: Don’t commit fraud. Be very careful about billing related mistakes.
5. Have both electronic and manual processes, double-checks, and internal reviews in place to prevent erroneous claims and to discover any errors before the government (or a whistleblower) does. If you do discover irregularities, get counsel immediately because the clock will be ticking as to the return of overpayments.
