Share this article

print logo


The federal agency that oversees Medicare is investigating the University at Buffalo School of Medicine and Biomedical Sciences to see if doctors-in-training affiliated with the school improperly billed Medicare for services.

The investigation at UB, which is being conducted by the Western New York Health Care Fraud Task Force, is noncriminal at this time.

Federal officials said the task force is looking into whether some medical residents billed Medicare at a rate that should be charged by faculty physicians. The extent of the alleged fraud was not revealed.

The task force is coordinated by the U.S. attorney's office in Buffalo, and also includes investigators from Health and Human Services.

"The concern is that some students are coming out of med school already schooled in how to defraud the system," one law enforcement official said today.

Officials began requesting documents from UB shortly after Jan. 1, said Dr. Michael E. Bernadino, UB's vice president of health affairs.

"I can only confirm that an audit is taking place. I really don't know the full extent of what they are looking at," he said.

"I would add, though, that the audit doesn't automatically mean there's a problem," he said.

Dozens of medical schools throughout the nation have faced similar investigations by the U.S. Department of Health and Human Services. The separate audits are part of a nationwide probe called PATH, or Physicians at Teaching Hospitals.

Federal officials said the investigation at the UB medical school concerns billing issues and is "PATH-like," but is not a part of the PATH probe.

PATH has looked at such issues as whether medical school faculty were physically present for procedures performed by residents and later billed to Medicare, as required under federal rules. In 1998, for instance, the University of Pittsburgh, its affiliated hospitals and 18 physician group practice plans run by the medical school agreed to pay $17 million to the federal and state governments because of allegations of such overbilling.

Health and Human Services administers Medicare, the government health program for the elderly. Medicare also pays teaching institutions for training new physicians and provides money for their salaries.

The PATH audits have caused controversy because medical schools and their affiliated hospitals contend confusion has existed for many years over the standards that teaching physicians must fulfill and document to support Medicare billing for their services when medical residents are involved in the care of their patients.

There are no comments - be the first to comment