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1 Sep 2022, 5:05 pm
., a manufacturer of durable medical equipment (DME) based in Pittsburgh, Pennsylvania, has agreed to pay over $24 million to resolve False Claims Act allegations that it misled federal health care programs by paying kickbacks to DME suppliers. [read post]
1 Mar 2023, 12:35 pm
The investigation involved DME that was “manually priced” by Medicaid payors in Kentucky, Missouri, and D.C. [read post]
11 Mar 2010, 10:23 am
(Lily Orthopedic), which also provided DMEs to Medicare beneficiaries in Miami. [read post]
18 Dec 2006, 5:39 am
The Court acknowledged that federal law permits DME suppliers to use a CMN to assist in submitting claims. [read post]
2 Oct 2009, 1:03 pm
" The OIG Work Plan includes: - Reviewing Part B payments for services rendered in home health episodes; - Reviewing claims submitted by home health agencies to determine the accuracy of the billing codes and to identify miscoding patterns; - Determining whether payment methods for home health agencies should be adjusted by reviewing the home health agency cost data and profitability trends; - Reviewing CMS' role and procedure in ensuring HHA submits accurate OASIS data; - Reviewing… [read post]
27 Jan 2012, 10:19 am
The DME MAC will notify the supplier when payment has been made. [read post]
30 Nov 2010, 9:41 pm
KO began billing Medicare for fraudulent DME in 2007, according to court documents. [read post]
1 Oct 2019, 3:42 am
In addition, Montgomery and Davis took a number of steps to conceal their illegal agreement, including making kickback payments through a nominee, creating and filing false tax documents, and, for Davis, intervening as CEO to prevent the owners of CPS from obtaining their own Medicare DME supplier numbers that would have allowed CPS to bill for its own Medicare DME orders. [read post]
16 Jun 2016, 7:17 am
Respironics allegedly provided DME companies with call center services to meet their patients’ resupply needs at no charge as long as the patients were using masks that Respironics manufactured; otherwise, the DME companies would have to pay a monthly fee based on the number of patients who used masks manufactured by a competitor of Respironics. [read post]
6 May 2021, 6:07 am
The two individual NPs pled guilty to conspiracy to commit healthcare fraud through their involvement in a plan related to DME, specifically braces used in orthotics. [read post]
22 Jan 2010, 9:05 am
They are accused of submitting approximately $179 million in fraudulent claims to Medicare for DME that had not been prescribed or ordered by a physician nor delivered to a Medicare beneficiary.Based on those claims, it is alleged that Medicare paid the DME companies approximately $56 million. [read post]
8 Sep 2022, 8:22 am
” The U.S. government alleged that the DME company caused claims to be submitted to Medicare, Medicaid, and TRICARE. [read post]
26 Feb 2009, 3:53 am
The claims concerned a Hialeah-based DME company operating as Med-Pro of Miami, Inc ( "Med-Pro" ). [read post]
1 Nov 2019, 3:47 pm
The Centers for Medicare & Medicaid Services (CMS) has adopted — with limited changes — its controversial plan to rewrite Medicare pricing rules for new items of durable medical equipment (DME), prosthetics, orthotics and supplies (DMEPOS) as part of its annual DMEPOS policy update for calendar year (CY) 2020. [read post]
19 Aug 2019, 4:09 am
The Centers for Medicare & Medicaid Services (CMS) is planning a potentially-significant overhaul of Medicare pricing rules for new items of durable medical equipment (DME), prosthetics, orthotics and supplies (DMEPOS) as part of its proposed annual DMEPOS policy update for calendar year (CY) 2020. [read post]
1 Mar 2012, 8:38 am
Medicare has been revoking the Medicare provider numbers of many different Medicare providers including physicians, medical groups, home health agencies (HHAs), pharmacies, and durable medical equipment (DME) providers, … Continue reading ? [read post]
9 Aug 2012, 6:51 am
Promed Orthocare Supply, Inc. v Travelers Ins. [read post]
20 Aug 2021, 10:41 am
Specifically, Harry is alleged to have solicited illegal kickbacks and bribes from durable medical equipment (DME) suppliers and marketers in exchange for orders involving DME braces and medications. [read post]
29 Apr 2025, 7:48 am
Empire also paid kickbacks to telemedicine companies, which then paid kickbacks to doctors for DME prescriptions. [read post]
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]
