Various physicians in Memphis will pay more than $340,000 for allegedly overcharging the taxpayer-funded Medicare.
This, according to a press release that U.S. Department of Justice officials posted on their website this week.
“Doctor Shoaib Qureshi, Doctor Imran Mirza, Memphis Primary Care Specialists, Lunceford Family Health Center, and Getwell Family Medicine agreed to pay $341,690 to resolve allegations that they violated the False Claims Act by knowingly charging Medicare for services rendered by nurse practitioners at the higher reimbursement rate for physician services,” according to the press release.
Qureshi and Mirza are family medicine physicians who practice in and around Memphis. Qureshi owns and operates Memphis Primary Care Specialists and Lunceford Family Health Center. Mirza owns and operates Getwell Family Medicine, the press release said.
Michael Dunavant, U.S. Attorney for the Western District of Tennessee, said in the press release that false Medicare billing encourages fraud, waste, and abuse of taxpayer money.
“Settlements like this achieve provider accountability, protect public funds, and safeguard the beneficiaries of federal health care programs,” Dunavant said.
Medicare pays a higher rate for physician services than for non-physician services. Medicare will pay the higher physician rate for services rendered by non-physician providers if the services are “incident to” the services of a physician. A physician must directly supervise such “incident to” services, according to the press release.
“The United States alleged that, from 2015 to 2018, Doctor Qureshi, Doctor Mirza, and their clinics billed Medicare as though the physicians had provided the services in question, when in fact nurse practitioners had treated the patients without the supervision required by Medicare’s ‘incident to’ rules,'” the press release said.
“Indeed, the government alleged that the services were rendered when the physicians were out of the office, including times when they were traveling out of state or abroad.”
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