Skip to Content
Blog

Article Highlights Excessive Medicare Billings

The New York Times recently reported on Medicare billing data which was released over the opposition of the American Medical Association and other industry groups. The data revealed that a single practitioner in Brooklyn in 2012 submitted billings for $4.1 million from Medicare. The Brooklyn practice of Wael Bakry, a physical therapist, reported seeing 1,950 Medicare patients in 2012. On average, the practice was paid by Medicare for 94 separate procedures for each patient.

Federal regulators have increasingly targeted unscrupulous practitioners who routinely bill Medicare for unnecessary treatments or procedures they never perform. Those practices are often easier to get away with in physical therapy than in specialties such as oncology or cardiology. Medicare paid physical therapists working in offices $1.8 billion in 2012 alone, the 10th-highest field among 74 specialties.

Enforcement efforts by federal authorities are yielding results. In 2011, a Brooklyn physical therapist pleaded guilty to submitting nearly $12 million in false and fraudulent claims to Medicare over a period of five years. In 2013, the owner of a Brooklyn medical clinic was sentenced to 15 years in prison for her role in a $77 million fraud in which patients were paid cash kickbacks to induce them to remain silent about services, including physical therapy, that were not provided but were billed to Medicare.

Individuals with knowledge of fraudulent or unscrupulous billing practices should speak with an attorney knowledgeable of False Claims Act cases. Individuals who report fraud (“whistleblowers”) stand to receive significant payments in the event fraud on the government is proved and a recovery is obtained.

Free Consultation
Martin & Jones, PLLC logo

“Forest, once again, my family and I thank you for obtaining another settlement on behalf of my Father. It’s almost uncanny that these checks seem to come at very opportune times. This one comes as we are expecting our fourth grandchild. It will provide her some sound footing towards her future college education, plus help Mom and Dad with the medical expenses. Sometimes, I think my Dad is helping you guys with this. Maybe so. Anyway, thank you again for your hard work.”

Martin & Jones, PLLC. Badges
Martin & Jones, PLLC. Badges
Martin & Jones, PLLC. Badges
Martin & Jones, PLLC. Badges
Martin & Jones, PLLC. Badges
Martin & Jones, PLLC. Badges

Contact Our North Carolina Personal Injury Law Firm

for a Consultation for Your Accident or Medical Malpractice Claim

Call us at 800-662-1234
Free Consultation

The law firm you choose makes a difference. If you are the victim of an accident or an illness that someone else caused, the North Carolina personal injury law firm of Martin & Jones has the depth of experience, skills and sensitivity to make your road to recovery as smooth as possible. Whether you have experience with the legal system or have never hired a medical malpractice or personal injury lawyer before, our attorneys and staff will do our best to answer your questions, provide clear advice and prepare you and your family for what to expect. If you would like more information or to meet with one of our attorneys, please fill out the form below or call us at 800.662.1234.