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HHS Inspector General Reiterates Commitment to Combating Healthcare Fraud, Highlights Areas of Focus
23 Apr 2024, 11:57 am
” Durable Medical Equipment (DME) Fraud: DME fraud “persisted in traditional Medicare for decades and is growing in Medicare managed care. [read post]
5 Apr 2024, 8:59 am
Richardson knew that these DME suppliers would use the signed orders to submit claims to Medicare for DME that was medically unnecessary, based on false documentation and tainted by kickbacks. [read post]
16 Feb 2024, 2:35 pm
In announcing the settlement, Damian Williams, US Attorney from the Southern District of New York, stressed the importance of billing government healthcare programs only for medically necessary services and products: When DME suppliers like Lincare knowingly seek federal funds for items that are not medically necessary and not being used, they threaten the sustainability and financial integrity of vital federal health care programs like Medicare and Medicaid. [read post]
15 Feb 2024, 12:37 pm
., a large durable medical equipment (“DME”) supplier with approximately 700 locations throughout the United States. [read post]
2 Feb 2024, 1:11 pm
Attorney for the District of South Carolina announced that Durable Medical Equipment (DME) companies Hill-Rom Holdings, Inc., Hill-Rom Company, Inc., Hill-Rom Services, Inc., and Advanced Respiratory Inc. [read post]
15 Dec 2023, 12:03 pm
Class members who registered for the recall before September 7 and returned their devices to Philips or their durable medical equipment (DME) providers are entitled to automatic payments of settlement benefits and will not need to file a claim. [read post]
15 Dec 2023, 6:56 am
A Texas man could serve more than 20 years in prison if convicted of health care fraud for his alleged role in a $60 million health care fraud, wire fraud, and kickback scheme involving the submission of false and fraudulent claims to Medicare for medically unnecessary durable medical equipment (DME), genetic tests, and foot bath […] [read post]
7 Dec 2023, 8:45 am
Parties in any affected cases received an audit trail of deleted videos, which was uploaded to DallasCountyProsecutor (DCP, formerly known as TechShare Prosecutor) by DPD’s DME Unit. [read post]
8 Nov 2023, 10:19 am
LexisNexis has selected some recently issued noteworthy IMR decisions that illustrate the criteria that must be met to obtain authorization for a variety of different medical treatment modalities. [read post]
29 Oct 2023, 10:08 pm
Licensing requirements may not apply to personal DME sales on e-commerce sites, but local laws should be consulted just in case. [read post]
10 Oct 2023, 10:51 am
During FY 2022, the Centers for Medicare and Medicare Services (CMS) has estimated the Medicare Part B improper payment rate as 8.41%. while the improper payment rate for Durable Medical Equipment (DME) suppliers was estimated to be 25.24%.[2] Additionally, the Medicaid program improperly paid $80.6 billion in improper claims during FY 2022.[3] Notably, these estimates don’t even take into account the sizeable improper billings submitted to private payors. [read post]
10 Oct 2023, 5:19 am
.' And the stylized DME mark is a clear reference to the company’s name, as shown on the webpage for DME STEEL. [read post]
28 Sep 2023, 1:12 pm
Read More Healthcare & Pharmaceutical Fraud Medically Unnecessary Services Medical Devices and DME Fraud I Think I Have a Whistleblower Case Contact Us Confidentially Read Nurse Practitioner Convicted in $200 Million Medicare Fraud Scheme at constantinecannon.com [read post]
8 Sep 2023, 8:41 am
Lincare, a durable medical equipment (“DME”) provider, will pay $29 million to settle a False Claims Act case filed in 2021. [read post]
16 Aug 2023, 11:52 am
Finally, in May and June 2020, CRACCHIOLO and Partner-1 acquired five of their own fraudulent DME supply companies and themselves used fraudulent DME orders to file more than $11 million in fraudulent Medicare claims, seeking payment to the DME suppliers that CRACCHIOLO and Partner-1 controlled. [read post]
14 Aug 2023, 7:13 am
(emphasis applied) [8] The concerns noted in this blog post regarding mail or home delivery of DME to Medicare beneficiaries relate only to DME that such beneficiaries obtain from their physicians who also order the DME for the beneficiaries. [read post]
31 Jul 2023, 1:10 pm
., No. 2:18-cv-00254 (DME) The whistleblower was represented by Amy Easton of Phillips and Cohen and the whistleblower will receive approximately $3.8 million. [read post]
31 Jul 2023, 1:05 pm
., No. 2:18-cv-00254 (DME) The whistleblower was represented by Amy Easton of Phillips and Cohen and the whistleblower will receive approximately $3.8 million. [read post]
28 Jun 2023, 1:17 am
A Defense Medical Examination [DME] is an adversarial proceeding. [read post]
29 May 2023, 10:00 am
Medicare Advantage Plans are Aggressively Denying Claims – Administrative Appeals are Growing (May 25, 2023): According to the latest data released by the Centers for Medicare and Medicaid Services (CMS), beneficiaries participating in Medicare Advantage[1] plans now surpass those enrolled in original Medicare plans. [read post]
