American College of Physicians: Internal Medicine — Doctors for Adults ®

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OIC says it is not gunning for doctors

From the March 1999 ACP-ASIM Observer, copyright © 1999 by the American College of Physicians-American Society of Internal Medicine.

Despite an increased emphasis on detecting fraud and abuse, the HHS Office of Inspector General (OIG) is not seeking to punish physicians for simple billing errors or inadvertent mistakes, according to OIG chief counsel D. McCarty "Mac" Thornton.

"We don't view the practice of medicine as a criminal enterprise," said Mr. Thornton at a January meeting of the ACP-ASIM Medical Services Committee. Only 21 physicians were convicted of fraud last year, he said. Those convictions included cases where physicians billed for services not rendered, received kickbacks for promoting durable medical equipment and illegally sold prescription drugs.

"Those are the things we go after ... not billing errors, negligence or honest mistakes," Mr. Thornton told the committee. In most instances, he said, physicians are encouraged to work with carriers to iron out any problems like insufficient documentation and incorrect coding.

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