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Coding Issues Land Life-Saving Doc Behind Bars

Joe Cantlupe, for HealthLeaders Media, February 14, 2013

Prosecutors and the Association of American Physicians and Surgeons agree that Natale's case should have a profound impact on physicians. They disagree sharply over what that message is.

"The need for deterrence is very strong in a case like this," said U.S. Attorney Amarjeet Singh Bhachu when Natale was sentenced. "A message needs to be sent out to doctors." The sentencing judge, Rebecca Pallmeyer, noted that "accurate coding is of extraordinary importance."

"The message to doctors is not to take Medicare money," Jane Orient, executive director of the AAPS, told me. "If you take it, you must comply perfectly with requirements, and this is impossible. They can't prosecute everyone of course; they could prosecute anyone."

The AAPS has joined in an appeal of Natale's conviction. It said that the criminalization of language used in medical reports would have a profound impact on the practice of medicine.

"The chilling effect caused by this conviction, if upheld, is undeniably profound for many physicians," the AAPS stated in papers filed with the court. "Physicians will now need to practice 'defensive documentation,' taking more time away from patient care in order to double-check and triple-check their operative notes—or say less in their notes—lest a few inevitable errors be used to incarcerate them and destroy their careers."

"This precedent criminalizes false statements in a private setting without any proof of billing fraud and a greater interference with the day to day practice of medicine is difficult to imagine," the AAPS added.

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17 comments on "Coding Issues Land Life-Saving Doc Behind Bars"


Sarah (11/20/2013 at 10:06 PM)
Ann I was a nurse for Dr. Natale I assisted himb on many surgeries. I find your comment disqusting and everything that is wrong with medicine. Dr. Natale life was his patient's, he was one of the best surgeon's in practice, and many of us medical practitioner's sent our family to him including my mom. I think your confused! This doctor was the best in the business more will fall just like him.

Ann (10/22/2013 at 5:46 PM)
My family member is a victim of this mans unnecessary surgery and fraudulent behavior Her leg was sliced up and down when a simple incision would have repaired her problem Her choice to not pursue this due to the further duress it would cause is lucky for Dr Natale

Ann (2/26/2013 at 8:28 PM)
Dr. Thomas Painter was the doc that went to the prosecutors to report Dr. Natale in an effort to remove the doc he considered his "economic competitor" (as the prosecution stated). Unfortunatesly, over time too many that came to see Dr. Painter at Northwest Hospital...heard of Dr. Natale and his amazingly positive surgical record (never loosing even One patient on the operating table)... And as a result moved from Painter to Natale. Now Painter had been sued, and often, while Natale never, not once, had been sued. That is extremely unusual...and Painter was twisted with jealousy and resentment.... Painter went to the US Attorney's hoping to sell them the prosecution ...the GOvernment wanting to prove awful doctors were thieves stealing from Medicare in light of the publics outrage over Obamacare...wanted the show trial ..and the prosecution...WHen not one Doc approached would agree to testify ageing Natale as the Exoert Witness....Painter went out and got an old med School chum..who by the grace of the US government was given a lofty promotion...and Painters buddy agreed to testify.... Don't you just feel slimed reading about this? What the heck has happened to our government? Are they willing to intimidate and incarcerate so other Docs and all patients comply??? Such an incredible injustice ...Free Doctor Natale...Free a good decent, competent surgeon...He did no wrong!! If there was no exact code for what they called a "coding error"...If MEDICARE HAS TO CREATE 1500 NEW CODES EVERY YEAR....WHY ARE THERE NOT 1500 Other Docs in Prison every year! This is political...and a disgrace...Patrick Fitzgerald himself should be in prison for this twisted prosecution ...Shameful Free Dr. Natale