Tag Archives: Boston Medical Center Corporation

Emerging Compliance Issue: Recent False Claims Act Settlements Based on Improper Billing for Evaluation and Management Services by Physicians

An emerging health care compliance issue for hospitals and health systems is a potential liability under the Federal False Claims Act (FCA) based on billing for evaluation and management (“E & M”) services provided by employed physicians. Although potential liability for billing for E&M services (i.e., office visits) is not new, several recent FCA settlements should remind hospitals and health systems that the government may consider the submission of claims for E&M services under improper codes to result in a false claim. Continue reading