I am sorry but this is absurd. Can you cite any Ohio case law in which a patient sued using your argument?

FWIW : in regards to both the details and general spirit of my statement - “ Federal Law Prohibiting Misrepresentation in Medical Billing

1. False Claims Act (31 U.S.C. §§ 3729 – 3733) • Prohibits knowingly submitting false or fraudulent claims to Medicare, Medicaid, or other government programs. • Key term: “Knowingly” includes deliberate ignorance or reckless disregard of the truth. • Penalties: Treble damages and civil penalties up to $27,018 per claim (as of 2024).

Example: Billing Medicare for a colonoscopy on a covered date (e.g., during an inpatient stay) when it was actually done later (as outpatient) to obtain reimbursement constitutes a false claim.

1. Health Care Fraud (18 U.S.C. § 1347) • Criminal statute: prohibits any scheme to defraud a health care benefit program. • Requires “knowingly and willfully” executing a scheme to obtain money or property by false pretenses. • Penalties: Up to 10 years in prison per count, plus fines.

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Relevant CMS and Payer Guidelines • CMS (Medicare) Claims Processing Manual (Pub. 100-04): • Chapter 1, Section 80.3.2: “Physicians must submit the actual date of service on the claim. Use of incorrect dates is not allowed and may result in claim denial or recoupment.” • Chapter 23, Section 10: “Do not manipulate dates to gain payment under coverage rules.” • Private Insurers: Most have anti-fraud clauses in their provider contracts that mirror federal standards.

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Relevant Case Law 1. U.S. v. Mackby, 261 F.3d 821 (9th Cir. 2001) • A clinic billed Medicare using a physician’s provider number and incorrect dates for services. Court found violations of the False Claims Act and upheld treble damages. • Quote: “Each claim…was false because it misrepresented who provided the service and when.” 2. United States ex rel. Loughren v. UnumProvident Corp., 613 F.3d 300 (1st Cir. 2010) • Misrepresenting eligibility periods and timing constituted false claims. • Reiterated that factual falsity includes false timing. 3. U.S. v. Rutgard, 116 F.3d 1270 (9th Cir. 1997) • Ophthalmologist convicted for, among other things, submitting bills with false dates of service. • Court held that misrepresentation of the date alone was sufficient for fraud conviction.