Maintaining Ethics in the Healthcare Setting - Course Q&A

The following is an excerpt from a LIVE webinar Q&A for the CEU course titled 'Maintaining Ethics in the Healthcare Setting'.

Q: Can we lose our license for changing the date of a treatment within the cert period in the case that an evaluation was done that day? The patient was re-evaluated but you arrive for the visit as a PTA. You change the date for the next day. Is it unethical? Can you even face action? Seems to be common practice.

A: You could trigger an investigation. Or if a surveyor found that error, they could fine the facility and withdraw the Medicare or 3rd party reimbursement. If you find an error like that, it's always best practice to back out the charges yourself and resolve the situation to make it right. Always document for services for the actual day of treatment.

Whether or not you face action will depend on the OIG auditor and the state or federal surveyor. I've seen it go both ways... If you prove you were honestly trying to do the most ethical thing, they may just fine the facility and watch to make sure it doesn't happen again. But if they think you're trying to cover something up, they may continue to investigate until they could take your license. I've also seen a lot of companies just fire the therapist in question.

Q: Are there any references for specific cases and their resolution?

A: Regarding references, you could probably google: PT (Or OT or SLP), cases regarding dates of patients seen, documented wrong dates... or some combination of words like that... I've just personally seen cases around the U.S when I worked in compliance & education. There tends to be more cases in LA & FL for some reason. Unfortunately, many people keep their fraudulent cases quiet and just fire people, hoping it will not make the news. By the time it hits the news (and could then be found by Googling such incidences) it is a legal case with huge fines & or jail time.

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