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Before starting this forum, please review the following:
Unbeknownst to a physician in private practice, her medical assistant has been falsifying ICD-10-CM and CPT codes to ensure a greater reimbursement from insurers (including from the federal government for Medicare), and has been pocketing the difference.
The Federal Office of the Inspector General conducts an audit based on a tip from a former employee, and uncovers the scheme.
What, if any, is the physician’s criminal liability in this case? Why? Please note any regulations or court decisions that support your point of view.
