Updated on: October 12, 2017

Wronged by Medicare? A Doctor’s Story

Original story posted on: October 13, 2017

CMS has accused Bryan Merrick, MD of wrongful Medicare billings on 10 patients over a span of 20 months.

Bryan Merrick, MD, a physician at the Tennessee-based McKenzie Medical Center who has been practicing medicine for more than three decades, will be a central topic of conversation during the next edition of Monitor Mondays, as the Centers for Medicare & Medicaid Services (CMS) has pulled his Medicare billing privileges due to what have been described as simple clerical errors.  

The broadcast will take place at 10 a.m. ET on Monday, Oct. 16.

Dr. Merrick has said that CMS revoked his Medicare billing privileges for three years in April. He claims he was dropped from the Medicare program because he billed Medicare for 10 patients he didn't see.

However, he argues that the billing mistakes were errors. For example, he said in one case, a staff member mixed up two patients with identical names.

"I didn't do anything personally wrong, professionally wrong, or unethical," Dr. Merrick told WBBJ.

He said CMS is questioning a total of $670 in services billed over a 20-month period. The federal government reviewed 30,000 claims submitted by Dr. Merrick, and only 30 billings for 10 patients were identified as improper, less than one-tenth of 1 percent.

Dr. Merrick appealed the CMS decision, but his appeal was denied in August. He plans to take his case before an administrative law judge, but there is not a set timeline for that process, according to The Jackson Sun. He has also enlisted the help of former Tennessee State Sen. Roy Herron, an attorney for Dr. Merrick, who is asking U.S. Rep. David Kustoff (R-Tenn.) and Sen. Lamar Alexander (R-Tenn.) to review the case.

“The local hospital has lost its only internist and the local nursing home has lost its medical director,” Herron said.  “The medically underserved region is in danger of being even more desperately underserved.  And thousands of patients will soon be at risk when they are without their long-time physician.”

"This is the worst and most egregious abuse of an individual by government that I have seen in over a quarter-century of dealing with the government," Herron added.

Herron will appear on Monitor Mondays to discuss the case. 

Mark Spivey

Mark Spivey is a national correspondent for ICDmonitor.com, RACmonitor and ICD10monitor who has been writing on numerous topics facing the nation’s healthcare system (and federal oversight of it) for eight years.

This email address is being protected from spambots. You need JavaScript enabled to view it.

Related Articles

  • CMS Eliminates Reporting of Functional Limitation Codes
    CMS also has updated its therapy manuals, making elimination of FLR official. Many therapy providers, at hospital outpatient departments and private-practice clinics alike, were reluctant to stop submitting functional limitation reporting codes and impairment modifiers until they could see the…
  • The Hard Fact About ABNs in the ED
    Weighing the difficult decisions being made in the business of healthcare. Medicine has commonly been considered one of the most altruistic professions.  From long years spent in training to long hours spent caring for others and the perpetual drive to…
  • Medicare Advantage Plans Often Decline Authorizations for Long-term Acute Care (LTAC) Transfers
    Patients “managed” out of benefits on Medicare Advantage programs. Administrative overhead for Medicare fee-for-service operations typically runs at approximately 2-3 percent. Overhead for commercial insurance plans has been reported to be 18-20 percent. So, what services are being denied by…