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Texarkana doctor resolves Medicare billing fraud allegations with $118K settlement

Texarkana doctor resolves Medicare billing fraud allegations with $118K settlement

May 20th, 2019 by Lynn LaRowe in Texarkana News

A doctor with clinics in Texarkana, Texas, and New Boston, Texas, has agreed to pay $118,000 to the government to resolve allegations of improper Medicare billing, the U.S. Attorney's Office for the Eastern District of Texas announced last week.

Dr. Donald S. Douglas, 50, is an internist operating three clinics in Texarkana and New Boston. According to the U.S. Attorney's Office, Douglas utilized Advanced Practice Nurses in his clinics.

"Under Texas law, APNs may perform certain duties such as treating and diagnosing patients, performing exams and other functions," the release states. "If the services are provided with proper physician supervision, they may be billed to Medicare under the full physician rate. Without direct supervision, APNs may bill Medicare under their own identification number at a reduced rate."

The government alleged that Douglas billed Medicare for APN services at the full physician rate even when no doctor was available to supervise their work.

"Pursuing healthcare fraud is a top priority for my office," said U.S. Attorney Joseph D. Brown. "When providers such as Dr. Douglas enrich themselves at the expense of Medicare, we will hold them to account."

Under the terms of the settlement agreement, Douglas admits no liability. The government is not alleging that services were not provided or that patients received poor or inferior care. Douglas cooperated with the investigation.

Medicare is a federally-funded healthcare program for persons 65 and older or who receive Social Security disability. Agencies involved in the investigation include the U.S. Attorney's Office for the Eastern District of Texas; U.S. Dept. of Health and Human Services; the FBI and the Office of the Inspector General. Assistant U.S. Attorney James Gillingham negotiated the civil settlement on the government's behalf.

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