Prosecutors Vigilant to Questionable Medicare Bonuses

A settlement with a billing company in Massachusetts is just the latest outcome of federal prosecutors going after healthcare companies for return of Medicare bonuses claimed in error. It’s a reminder that filing for claims improperly—even if inadvertently—can have serious consequences for operators. In this case, Medical Reimbursement Systems Inc. has agreed to pay $500,000 to settle allegations that it submitted false claims to the military’s Tricare program on behalf of a medical practice in Watertown, NY. The government had charged that the company wrongfully claimed it was eligible for 10% Medicare bonuses for areas designated as having a shortage of health professionals. In addition to the financial settlement, the company has agreed to hire an outside consultant to train its staff on Tricare billing training and to appoint a new compliance officer. Had these been in place before the infractions occurred, of course, penalties could have been avoided.