Doctor to pay $118K to settle claims of improper Medicare billing practices

The physician operates clinics in Texarkana and New Boston, Texas

Doctor to pay $118K to settle claims of improper Medicare billing practices

TEXARKANA, Texas (KSLA) - An East Texas physician has agreed to pay $118,000 to settle allegations of improper billing practices for Medicare patients at his three clinics, U.S. Attorney Joseph D. Brown announced Tuesday.

Dr. Donald S. Douglas, 50, operates clinics in Texarkana and New Boston.

Allegations against Douglas, as stated in the settlement agreement, say advanced practice nurses were hired to help him see patients.

Under Texas law, APNs or mid-level practitioners may perform certain duties such as treating and diagnosing patients, performing exams and other functions.

And if the services are provided with proper physician supervision, they may be billed to Medicare at the full physician rate.

Without direct supervision, however, APNs may bill Medicare under their own identification number and at a reduced rate.

Douglas allegedly billed Medicare for services provided by his APNs at the full physician rate even when a physician was unavailable to supervise their services, federal prosecutors allege.

“Pursuing health care fraud is a top priority for my office,” Brown said. “When providers such as Dr. Douglas enrich themselves at the expense of Medicare, we will hold them to account.”

Under the settlement, Douglas does not admit liability.

And prosecutors do not allege that the services were not provided or that Douglas’ APNs provided inferior care.

Douglas cooperated with the government’s investigation and will pay $118,000 to settle the allegations, Brown said.