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BUSINESS FRAUD RISKS
True Case Report
By Dr. David Edward Marcinko MBA CMP©
SPONSOR: http://www.CertifiedMedicalPlanner.org
A Medical Practice Misrepresentation Case Model
Let’s say a physician decided to sell his practice and move to another state. The value of the sale was based, in part, on the yearly gross of the practice. The physician accepted installment payment terms from the buyer and moved to the new state. The buyer began to practice medicine at his new office. Although he was busy, his gross never approached the gross of the prior physician.
Eventually the buyer defaulted on the loan. The selling physician sued for the deficit. The defaulting physician and his forensic consultants then performed an in-depth evaluation of the seller’s practice. The buyer and his team noticed some discrepancies in the billing patterns and practices of the seller. Considering these discrepancies to constitute Medicare and insurance billing fraud, the seller counter-sued the buyer on the grounds of misrepresentation, alleging the gross receipts of the practice purchase price, was grossly inflated.
Citation: https://www.r2library.com/Resource/Title/0826102549
ASSESSMENT: Therefore, the buyer determined that the seller had fraudulently misrepresented the potential of the practice. He also notified state and federal authorities and filed complaints of insurance fraud against the seller.
The seller thought that he would move to the good life in the new state, but his old practice kept him in constant legal trouble.
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Filed under: Accounting, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Practice Management, Recommended Books, Risk Management | Tagged: David Edward Marcinko, Medical Practice Misrepresentation, Medical Practice Misrepresentation Risks, practice appraisal, practice fraud, practice value | Leave a comment »
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