HCFA probes physician billing number reassignment
At the Health Care Financing Administration's (HCFA) conference on fraud, waste, and abuse in Washington, DC, HCFA administrator Nancy-Ann DeParle unveiled the agency's plan to aggressively prosecute the abuse of physician billing number reassignment.
Although she acknowledged that physicians "sometimes have a legitimate need to reassign billing numbers to [one or more] clinics where they furnish care," DeParle maintains that reassignment can also be a source of abuse, with bills submitted for inappropriate care, for cases in which no care is provided, or for cases in which the physician was not physically present.
HCFA has already performed targeted reviews of reassignment arrangements at physician practices in Florida which suggested that "reassignment was clearly being abused." The agency claims some clinics were submitting claims under billing numbers of physicians who had not worked at the clinic in more than two years. "In other cases, claims were being submitted for care provided by a single physician in a single day from clinics that are hundreds of miles apart," the agency says.
At HCFA's conference, DeParle announced that the agency will begin performing similar reviews nationwide, targeting physicians with a large number of reassignments. Based on the results of these national reviews, HCFA may limit the number of reassignments a physician can make. In addition, the agency says it will step up enforcement of existing regulations, which require that physicians have information about what is billed in their names.
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