Medical Director Faces Prison Time, Fines for Saying He Spent More Time with Residents Than He Did

February 10, 2020 | Aging Services Risk, Quality, & Safety Guidance

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The medical director of two skilled nursing facilities has been sentenced to two months in federal prison and fined more than $316,000 for billing Medicare and Medicaid for longer visits than he actually made or did not make at all, according to a news release from the U.S. Attorney's Office for the Northern District of Iowa. The prison time and fine resolved False Claims Act allegations against the medical director.

The doctor began upcoding in January 2014. In July 2016, a Medicare contractor sent the doctor a warning letter stating that his billing patterns were substantially more expensive than those of other doctors. The U.S. Attorney's Office...

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