A family physician in Knoxville, Tenn., and his practice agreed to pay $285,000 to resolve allegations of improper billing to government healthcare programs, according to the Department of Justice.
The government accused Chang-Wen Chen, MD, and his practice of upcharging Tennessee's Medicare and Medicaid programs, as well as the military program Tricare, from 2013-19 for care that was provided by nurse practitioners.
While Tricare doesn't, Medicare and TennCare reimburse at a higher physician rate for services NPs or other nonphysician providers render under direct physician supervision. According to the government, Dr. Chen and his practice billed the government programs at the physician rate even when NPs weren't directly supervised.
The Justice Department began investigating the case after a former NP at Dr. Chen's practice filed a lawsuit under the qui tam, or whistleblower, provision of the False Claims Act in 2015. The NP will share in $51,300 of the settlement.
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