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21 Tenn. physicians sue over Medicaid payments

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Twenty-one Tennessee physicians are suing CMS  in  a U.S. District Court Monday to stop the agency from recouping $2.3 million in Medicaid payments.

“The payments were made in 2013 and 2014 to physicians serving rural communities and disadvantaged populations to help them expand their practices and provide more services in areas with limited care,” Becker’s Hospital Review reported.

“However, CMS required TennCare, the state’s Medicaid program, to audit the physicians to ensure that they are either board-certified or bill 60 percent or more of their Medicaid codes within certain billing- code categories. More than 100 physicians across the state didn’t meet these requirements, and so TennCare is now seeking repayment.”

Becker’s reported that, according to a press release from Bass, Berry & Sims, the lawyers who filed the lawsuit, “one of the plaintiffs reportedly used the funds to open an outreach clinic for bilingual uninsured patients, expanded hours and upgraded other services, and another plaintiff hired a bilingual nurse and an internal medicine specialist.”

“Bass, Barry & Sims predicts physicians who received similar payments in other states may eventually face similar repayments,”  Becker’s reported.

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