Psychiatrist not liable for fraudulent claims submitted under his name when he did not sign the submissions and was not aware of the claims or involved in providing the claimed services.
The Michigan Court of Appeals ruled a psychiatrist could not be held liable for fraudulent Medicaid submissions made by the company for which he worked as a consultant, even though the submissions were made under his name. Between 1991 and 1993, the company billed the state's Medicaid program for $142,560, using the psychiatrist's typed name and provider number, for services the psychiatrist did not provide. In conjunction with his employment, the psychiatrist had completed a form supplied by the state that allowed the company to use his provider number to submit claims and receive Medicaid payments. The form stated that both the company and the psychiatrist would be "jointly and severally liable" for any overpayments.
The court determined the psychiatrist was relieved from liability because the claim forms did not meet the statutory certification requirements as they contained neither his signature nor the name of the person typing his name on the claim forms. Thus, because the claims should not have been paid in the first place, the court concluded the psychiatrist could not be held jointly and severally liable for the overpayments. The court rejected the state's argument that the psychiatrist had a duty to ensure that all claims submitted under his provider number were accurate because here the psychiatrist was neither involved in providing these services nor did he have knowledge of the claims or payments. Silverman v. Director of Mich. Dep't of Community Health, No. 236473, 2003 WL 21702519 (Mich. Ct. App. July 22, 2003).
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|Publication:||Developments in Mental Health Law|
|Date:||Jul 1, 2004|
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