The Las Vegas Review Journal recently reported that a Las Vegas physician agreed to pay $5.7 million plus interest to settle allegations that he submitted false claims to various federal health care programs between 2007 and 2009. (See the full article here) I don't know the details of that case -- maybe he's a bad guy, maybe he just wasn't careful. Or it could be that he simply did not monitor and audit his billing procedures.
Failure to monitor and audit your billing procedures can lead to serious consequences –- not just in the loss of millions of dollars but also in criminal liability. There are resources out there to help you make sure you are compliant with the law. The Office of Inspector General for the U.S. Department of Health and Human Services (OIG) has developed a series of voluntary guidance documents to assist health care providers in establishing compliant and reliable auditing and monitoring systems. These documents can be found here: http://oig.hhs.gov/compliance/compliance-guidance/index.asp
It may be worth it to familiarize yourself with these guidelines. This will help protect you, your business, and the integrity of the federal health care programs.
