Failure to Adhere to Incident-to Rules Can be Costly

A stethoscope sitting on top of a medical billing statement.

The U.S. Department of Justice recently announced that two physicians and their family medicine practices located in Tennessee will pay $341,690 to resolve allegations that they violated the False Claims Act by knowingly charging Medicare for services rendered by nurse practitioners at the higher reimbursement rate for physician services. The providers are alleged to have…

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MedPAC: Eliminate “Incident to” Billing for ARNPs and NPs

A woman standing in front of an image.

If Congress adopts the Medicare Payment Advisory Commission’s (MedPAC), most recent recommendations, “incident to†billing could become a thing of the past for Advanced Registered Nurse Practitioners (ARNPs) and Physician Assistants (PAs). The recommendation to eliminate “incident to†billing for these providers was made in MedPAC’s biennial report issued in June. MedPAC is an independent…

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