OIG Alert: Physicians Should Exercise Caution When Reassigning Their Medicare Payments

On February 8, 2012, the Office of Inspector General (“OIG”) released an alert warning physicians to exercise caution when reassigning their right to bill and receive payment from the Medicare program.  According to the OIG, Physicians who reassign their Medicare provider benefits by executing a CMS-855R application may be held liable for false claims submitted by the assignee.

The alert discussed a recent settlement with eight physicians who reassigned their Medicare payments to various physical medicine companies in exchange for medical directorship appointments.  However, the claims that were subsequently submitted to Medicare for payment under the physicians’ reassigned providers numbers were performed by unlicensed, unqualified “technicians” without direct supervision by the physicians.  These actions resulted in criminal prosecution of many of the owners and operators of the companies and the imposition of civil monetary penalties on the physicians.

According to the OIG, the lesson for physicians is that they should use heightened scrutiny prior to reassigning their Medicare provider benefits and carefully screen potential assignees.  While it is common practice for physicians who are employed by hospitals and physician groups to reassign their provider benefits to their employer by executing a CMS-855R application, it is not common for such physicians to perform significant due diligence on the assignee entity before doing so.  The OIG’s alert was intended to remind physicians that it is not only their right inquire about a potential assignee’s compliance history, it should be standard practice to do so.  The OIG pointed out that reassigning physicians have an unrestricted right to access information about claims submitted to Medicare under their reassigned provider numbers.

You can find a copy of the OIG Alert here —> OIG Alert

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