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15 Aug 2011, 6:30 am
LOUISVILLE, KENTUCKY (AUGUST 15, 2011) - Although their durable medical equipment company was based in Florida, Yunior Lopez, 34, of Miami, Florida and Arturo Esquivel, 39, of Hialeah, Florida, had a 13-count indictment leveled against them regarding their false billings to Medicare on behalf of Kentucky patients. [read post]
18 Oct 2012, 10:00 am
The recruiter supplied the information to a durable medical equipment (DME) company.... [read post]
14 Jul 2009, 2:55 pm
In one week, six indictments and allegations of $282 million in fraud from DME, to Pain Management, to therapy. [read post]
13 Jul 2012, 10:00 am
These include home health agencies (HHAs), independent diagnostic testing facilities (IDTFs), ambulance and emergency transport providers, physicians, pharmacies, durable medical equipment (DME) providers, medical groups, physical therapists and therapy providers. [read post]
20 Dec 2012, 11:59 am
Devices that qualify as DMEPOS include: (a) prosthetic and orthotic devices as defined in 42 CFR 414.202, that do not require implantation or insertion by a medical professional; (b) parenteral and enteral nutrients, equipment, and supplies as defined in 42 CFR 411.351 and described in 42 CFR 414.102(b);(c) customized items, as described in 42 CFR 414.224; (d) therapeutic shoes as described in 42 CFR 414.228(c); or (e) supplies necessary for the effective use of DME, as described in section… [read post]
17 Jul 2012, 8:14 am
Of the 903,372 claims that the RACs alleged were overpaid, 197,739 or 21.8% came from Part A providers, 410,208 or 45.4% were submitted by Part B providers and 295,425 or 32.8% originated with DME providers. [read post]
31 Jul 2011, 1:05 pm
The written reports of these examinations, which I call defense medical examinations ("DME"), can be successfully challenged by an experienced plaintiff's lawyer. [read post]
6 Aug 2012, 5:20 am
In FY 2011, CMS reports that of the Part A appeals decided, 6,226 were favorable to the provider, 14,352 Part B appeals were decided favorably and 3,930 DME appeals were favorably decided. [read post]
1 Sep 2022, 6:06 am
When the DME physician opined that the injured worker had fully recovered, the insurance company filed a Petition for Termination. [read post]
31 Aug 2008, 6:27 pm
The best way to make a record is by videotaping the DME exam. [read post]
15 Feb 2012, 3:35 am
., Louisiana-based companies that fraudulently billed DME to the Medicare program from 2004 to 2009. [read post]
22 Aug 2009, 5:00 am
., a Hialeah-based company that purportedly provided durable medical equipment ("DME") to Medicare beneficiaries. [read post]
14 Feb 2012, 11:13 am
The "submitter" will submit to DME MAC a request for prior authorization and all relevant documentation to support Medicare coverage of the PMD item. [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]
9 Mar 2009, 12:04 am
Only deal with pharmacies, DMEs and other entities who have an excellent reputation and can be trusted with patient identification. [read post]
12 Aug 2010, 4:00 pm
The goal of this document is to guide the investigator through Best Practices to ensure that best evidence is the target of DME acquisition and that the integrity of the original data is maintained. [read post]
20 Jun 2011, 2:41 pm
Preferred Plus maintained a valid Medicare provider number in order to submit Medicare claims for the costs of durable medical equipment (DME) and purported to provide orthotics and other DME to Medicare beneficiaries. [read post]
20 Jun 2011, 2:41 pm
Preferred Plus maintained a valid Medicare provider number in order to submit Medicare claims for the costs of durable medical equipment (DME) and purported to provide orthotics and other DME to Medicare beneficiaries. [read post]
13 Sep 2016, 5:20 am
The OIG recommends that CMS seek a legislative change to base payments for DME infusion drugs on ASP; alternatively, CMS could use its existing authority to include DME infusion drugs in the competitive bidding program. [read post]
22 Jun 2011, 2:53 pm
STK maintained a Medicare provider number in order to submit Medicare claims for the costs of durable medical equipment (DME) and purported to provide orthotics, power wheelchairs, power wheelchair accessories and other DME to Medicare beneficiaries. [read post]
