Physicians Still Receive Medicare Payments Even After Being Banned From Government Programs

The release of data showing the dollar amount physicians received in Medicare Part B payments in 2012 has revealed some physicians continued receiving Medicare payments after being banned from state Medicaid programs for committing fraud, according to a ProPublica report.

In 2011, Mark Greenbain, MD, a psychiatrist, was arrested for his involvement in a Medicare fraud scheme in the Detroit area. Subsequently, Dr. Greenbain was banned from billing Michigan's Medicaid program, according to the report. 

However, data releases April 9 by CMS showed Dr Greenbain had been paid $862,086 I Medicare Part B payments in 2012, despite his indictment for Medicare fraud and his state Medicaid suspension, according to the report.

The data also showed many other physicians who had been terminated from state Medicaid programs and charged with healthcare fraud had received payments totaling $6 million in Medicare Part B payments in 2012, according to the report. 

Along with providing payments to physicians who had been banned from state funding prior to 2012, the recently released data also showed Medicare paid $17 million in 2012 to 28 physicians who have been charged with defrauding the Medicare program during the last 16 months.

Although Medicare has been criticized for its lack of diligence in fighting fraud, part of the problem lies in the individual states. Last month, HHS' Office of the Inspector General released an audit that revealed one-third of states hadn't reported the medical providers in their state who had been banned from Medicaid to CMS, according to the report.

More Articles on Medicare Fraud:

5 Recent FCA Employee Whistle-Blower Case Settlements 
Parallel Proceedings in Healthcare Fraud Investigations Are Becoming More Prevalent 

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