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  4.  → Dr. Bhadriraju denies the ABC News Report of improper billing, diagnosis was proper and Medicare was billed $41.08 for services

Dr. Bhadriraju denies the ABC News Report of improper billing, diagnosis was proper and Medicare was billed $41.08 for services

A recent ABC news report indicated that Dr. Padmini Bhadriraju might have been involved in improper billing practices.  Dr. Bhadriraju adamantly denies any wrongdoing or knowledge of wrongdoing.  Dr. Bhadriraju will take all legal actions necessary to protect her impeccable business and professional reputation, including but not limited to actions for libel and/or slander surrounding any statements indicating any wrongdoing on her part.  She continues to only seek to help the people of the Rio Grande Valley with management of the chronic diseases affecting the region.

“The story here is not a case of fraudulent billing practices on the part of Dr. Bhadriraju, but rather the inability of ABC News to understand Dr. Bhadriraju’s role in the treatment and diagnosis process of this patient and ABC News’ willingness to serve up a good doctor working for her community as a sacrificial lamb for the sake of headlines rather than do their jobs as reporters,” said John Rivas, Dr. Bhadriraju’s attorney.  “Dr. Bhadriraju did not diagnosis this patient as homebound and/or having type 2 diabetes as the ABC News Report suggests nor bill Medicare for thousands of dollars.  She billed Medicare $41.08 for the proper treatment of this patient’s hypertension, any suggestion to the contrary is simply false.”

The ABC Report is filled with errors and is patently false in the assertion, directly or indirectly, that Dr. Bhadriraju diagnosed a patient as either homebound or with type 2 diabetes.  From the outset the report seems to indicate thousands of dollars of fraudulent behavior on the part of Dr. Bhadriraju without disclosing not only did Dr. Bhadriraju not diagnosis the patient but also that she only billed Medicare $41.08 for any and all services rendered.

Dr. Bhadriraju treated patient for hypertension and made no diagnosis of diabetes .

The basis for referral of this patient was hypertension, which patient does not deny having.  This is clear across multiple pages of the medical record in the history and physical of Dr. Bhadriraju’s in-take form, the patient referral form, and the 485 that was provided to ABC News.  Dr. Bhadriraju’s own clinical records consistently document this patient’s diagnosis is hypertension (as stated by the patient, and as indicated by her medication profile).

Additionally, the 485 is not a form that is generated by Dr. Bhadriraju, nor any member of her clinical or administrative staff.  This is a form that is generated by the home health agency, in this particular case, My Morning Star Home Care, Inc.  At no point in the referral process did Dr. Bhadriraju, or any member of her clinical staff, in-put information into form 485 indicating the patient presented with a diagnosis of candidiasis or vaginitis, nor did they indicate these diagnoses verbally with My Morning Star Home Care, Inc.

Additionally, the patient was not referred to My Morning Star Home Care, Inc. for type II diabetes mellitus as alleged.  The “Patient Referral Form” provided by ABC News is, again, a form filled out by My Morning Star Home Care, Inc.  The section titled “Medical History/Diagnosis” is clearly written in another person’s hand-writing other than Dr. Bhadriraju.

Dr. Bhadriraju’s clinical findings in support of the need for home health services, as written in her own hand-writing, are “patients advanced age.  Moved into area locally.  Generally have need [sic] help with medication and blood pressure checks”.  This hand-written statement by Dr. Bhadriraju, again, clearly indicates the basis for referral is hypertension, not type II diabetes mellitus.

Furthermore, the patient referral form is not used as a basis for claim for payment.  Dr. Bhadriraju’s billing records do not support payment for these claims/diagnoses were submitted for payment for any government payments.  Dr. Bhadriraju billed Medicare $41.08 for her services in relation to the patient.

The copy of form 485 ABC News provided as evidence in support of their allegation of fraud has no physician signature in block 27 of this form.  This is a clear indication that Dr. Bhadriraju did not sign off on this plan of care generated by My Morning Star Home Care, Inc., thus did not concur with the secondary diagnoses identified on this form.

Shortness of Breath .

The ABC Report indicates the Medicare certification, and thus directly or indirectly that Dr. Bhadriraju, indicated the patient suffered from shortness of breath.  A review of Dr. Bhadriraju’s record show this is not the case.

As indicated in the record of Dr. Bhadriraju.  “Respiratory [status] “Negative”  … Genitorurinary [status] “Negative.  (Under respiratory status, DOE and SOB are listed as ‘checkable’ options.  Same under genitourinary, Incontinence is listed as an option.  Dr. Bhadriraju has marked both of these [body] systems as negative, indicating the patient did not have any complaints in these areas.

The Blood Test. .

The ABC News report suggests that she was not given a blood test which would have determined a diagnosis for diabetes was improper.

Dr. Bhadriraju wrote in her plan of care that she would like to do a blood test, but Ms. Ace stated she had recently had one done in New York.  Dr. Bhadriraju cancelled the lab test order and wrote “obtain record”.  (This ALSO illustrates how Dr. Bhadriraju was also not ordering specific things unnecessarily, because a lab test had been recently performed).

Dr. Bhadriraju denies any willful fraudulent activity.  Her intent for necessity of services is clear in the records that she has maintained, as well as the records obtained by ABC News.  The diagnoses of hypertension, osteoarthrosis, and anxiety support compliance with current health care regulations for appropriate and medically necessary care and treatment.  While there are, indeed, documentation errors in the records provided, these errors were not made by Dr. Bhadriraju, or her clinical staff.

The records provided by ABC News do not support any allegations of fraud.  We maintain the referral for home health services was proper.  ABC News never requested the records from Dr. Bhadriraju’s clinic, the person they are alleging committed Medicare fraud.  If they had requested such records they would have been able to determine the patient qualified for home health services based on the symptoms she presented with.  Lastly, it should be noted Dr. Bhadriraju has never had any allegation of misconduct previously and has a spotless record without incident.

Valley patients receive help from across the world. .

The ABC News story is not the story that should be told of Dr. Padmini Bhadriraju.  The real story is a familiar one to the old west.  A stranger from a strange place rides into a town to save the local populace from a nefarious villain.  This story is no different except that the hero of this particular story is a female doctor from a world away and the villain is the most slippery of bad guys: the chronic diseases that afflict the population of the Rio Grand Valley.

Each day when Dr. Padmini Bhadriraju arrives at her office she comes face to face with the villain she has chased across the globe. She first saw the chronic diseases she now battles not in a valley baked in Texas Sun, but in a place across oceans in her native land of India.

“The same illnesses that plagued my relatives and ancestors in India are found here in the Valley,” she explains.  “It is why I came here to practice because I wanted to fight the diseases I first saw growing up in India.”  As her clinics fill with patients, Dr. Bhadriraju knows that the battle is also trying to fight the diseases that will keep hospitals from overflowing.

“I try to keep patients out of hospitals when it is not necessary by providing good chronic disease management and trying to prevent costly exacerbations,” she explains.  “It is a battle, but the people of the Rio Grande Valley are worth the fight. I am just trying to do a small part in improving the quality of care and access to care for my patients through the clinics.”

For further information please contact:
John Rivas, Esquire
(512) 481-8000
[email protected]
3345 Bee Cave Rd, Suite 104
Austin, TX 78746
Rivas Goldstein, LLP