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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]
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]
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]
9 Aug 2012, 6:51 am
Promed Orthocare Supply, Inc. v Travelers Ins. [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]
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]
27 Feb 2012, 11:00 am
Family Healthcare maintained a valid Medicare provider number in order to submit Medicare claims for the costs of DME and purported to provide orthotics and other DME to Medicare beneficiaries. [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]
16 Mar 2010, 1:23 pm
DME companies are buying prescriptions. [read post]
29 Jul 2013, 10:21 am
In addition to ESRD policy changes, the proposed rule addresses Medicare coverage of and payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), including the definition of routinely purchased DME; the three-year Minimum Lifetime Requirement; and fee schedules for splints, casts, and intraocular lens (IOLs) inserted in a physician’s office. [read post]
16 Sep 2013, 2:30 pm
Two recent OIG reports point out the savings that state Medicaid programs could attain if they based reimbursement for DME, prosthetics, orthotics, and supplies (DMEPOS) on Medicare competitive bidding payment amounts – although at least one state is pushing back on this idea. [read post]
25 Feb 2015, 1:52 pm
Note that CMS announced on February 25, 2015 that Medicare FFS providers, clearinghouses, and billing agencies successfully participated in the first successful ICD-10 end-to-end testing week (from January 26 through February 3, 2015) with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor. [read post]
9 Apr 2014, 7:07 am
The files include data on services furnished by physicians, non-physician practitioners, laboratories, imaging, and ambulances, but not durable medical equipment (DME). [read post]
28 Apr 2016, 1:40 pm
"By contrast, here's Judge Paez's take:"In my view, DME suppliers do not exercise substantial professional or managerial discretion within Medicare’s reimbursement scheme because Medicare’s rules and regulations confine them to a ministerial role and leave all critical determinations of medical need to the beneficiary’s physician. [read post]
25 Jul 2014, 11:51 am
Finally, the proposed rule would make significant changes to Medicare reimbursement policy for DME, prosthetics, orthotics, and supplies (DMEPOS). [read post]
13 Mar 2013, 10:25 am
Recent OIG reports address DME infusion drugs, long-term care hospital reporting of co-location status, conflict-of-interest oversight for Medicare Part D pharmacy and therapeutics committees, Part B drug pricing, and skilled nursing facility care planning/discharge planning. [read post]
29 Sep 2012, 7:20 pm
(AP - Karen Rayburn, a 47-year-old Baton Rouge woman, who worked as a patient recruiter for several Louisiana durable medical equipment (DME) companies has been sentenced to 18 months in prison for her role in a Medicare fraud scheme. [read post]
15 Jan 2009, 12:09 am
., decided 1/9/2009)Appeal from a Queens Civil judgment for plaintiff DME provider on its motion for summary judgment.REVERSED and State Farm's cross motion for summary judgment was granted. [read post]
6 Jul 2012, 1:02 pm
From that 2012 medical journal article about Avandia and Actos being associated with diabetic macular edema (DME) eye disease: In conclusion, this large-population study has shown that, even after adjustment for a range of confounding variables, thiazolidinediones [(TZD) diabetes drugs, such as Actos and Avandia] are associated with an increased risk of DME in patients with type 2 diabetes, especially those undergoing insulin therapy. [read post]
11 Aug 2021, 12:18 pm
According to allegations in the superseding indictment, Harry and his co-conspirators solicited illegal kickbacks and bribes from durable medical equipment (DME) suppliers and marketers in exchange for orders for DME braces and medications. [read post]
