Cardiologist made to repay $100k in Medicare billings

A cardiologist has been made to repay $100,000 million for inappropriate billing of MBS items for longer consultations.

In its latest outcomes statement, the Medicare claims compliance watchdog, the Professional Services Review (PSR) said the un-named cardiologist had also received a reprimand and been disqualified from providing the MBS items for 18 months.

In its report, the PSR said its surveillance of cardiologists’ billing practices had identified that one practitioner was a high biller of MBS item 132. The item is for consultations of a duration of at least 45 minutes and can be billed once within a twelve month period by the same consultant physician

The PSR said it also identified concerns with the cardiologist’s billing such as MBS requirements (including minimum time requirements where relevant) not always being met. It said the practitioner’s records were inadequate, often brief and did not document relevant clinical information. It also found that the cardiologist had billed for services that were not clinically indicated.

“The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items of concern. The practitioner agreed to repay $100,000, to be disqualified from providing MBS item 132 for 18 months and will be reprimanded by the Director,” the PSR Update said.

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