Physician Practice Roundup—Doctor will pay $3M for improper billing of Medicaid and Medicare

justice
A doctor agreed to a $3 million settlement to settle claims he improperly billed Medicaid and Medicare. (Getty/designer491)

Doctor will pay $3M for improper billing of Medicaid and Medicare

A doctor who owned medical practices in Maryland and Delaware has agreed to pay more than $3 million to settle civil liability claims from improperly billed Medicaid programs in those states and the federal Medicare program.

The settlement with Zahid Aslam, M.D., was announced yesterday by Maryland Attorney General Brian E. Frosh. The settlement arose from an investigation into the billing practices of Aslam’s medical practices Fast Care, which did business as Got-A-Doc Walk-In Medical Centers and Amna Medical Center. The government alleged that the practices submitted improper claims for laboratory services and counseling and medical services.

As part of the settlement, the doctor agreed to surrender his medical licenses. Additionally, last month Aslam pleaded guilty in federal court in Delaware to healthcare fraud and making a false statement to a financial institution. He is scheduled to be sentenced in May. (Attorney General announcement)

Insurer-backed coalition forms to push efforts to stem 'surprise bills'

With the problem of surprise medical bills garnering growing national scrutiny, a group of insurance, business and consumer groups announced they've banded together to push for stronger patient protections.

Led by the likes of America's Health Insurance Plans, the National Business Group on Health and the Consumers Union, the new coalition is seeking legislative remedies such as requiring that patients be informed when care is out of network and know the cost of their treatment and options.

"When doctors, hospitals, or care specialists choose not to participate in networks—or if they do not meet the standards for inclusion in a network—they charge whatever rates they like," the group said in a statement. "The consequence is millions of consumers receiving surprise, unexpected medical bills that can often break the bank." (FierceHealthcare)

AMA backs states' suit over association health plans with a warning of fraud

The American Medical Association (AMA) urged a Washington, D.C., district court last week to block a rule finalized by the Trump administration to expand association health plans (AHPs). 

In an amicus brief (PDF) filed with the court last week, the AMA said the rule will undermine consumer protections in the Affordable Care Act (ACA), leaving patients "vulnerable to worse health outcomes and/or financial ruin." The association argued that AHPs could eliminate things like essential health benefits or pre-existing condition coverage, which would be particularly harmful to women.

The Trump administration finalized a rule to expand AHPs in June. Consumer advocacy groups and providers, including the American Hospital Association, quickly raised concerns about the loosened restrictions as officials celebrated the flexibility and choice for consumers. (FierceHealthcare)

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