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28 Feb 2011, 5:15 am
When identifying DME suppliers with a high volume of high utilization claims, enforcing the Medicare documentation requirements for claims for test strips and/or lancets, performing prepayment reviews of those suppliers, and referring those DME suppliers to the Office of Inspector General (OIG) or CMS for review or investigation. [read post]
5 Feb 2010, 6:10 am
First, elderly Medicare beneficiaries testified about how they were recruited into letting the DME company use their the scheme. [read post]
25 Feb 2010, 4:52 pm
Benjamin Essien, 34, owner and operator of Logic World Medical, a Houston-based durable medical equipment (DME) company, pled guilty to conspiracy to commit healthcare fraud, five counts of healthcare fraud and two counts of aggravated identity theft in the U.S. [read post]
10 Oct 2017, 3:07 pm
In accordance with Title 40, Part 1, Texas Administrative Code §19.2754(a), relating to Requesting Authorization to Provide Durable Medical Equipment and Customized Manual Wheelchairs, when a NF identifies a PASRR resident who requires DME or a CMWC, the NF must: • ensure a physical therapist or occupational therapist licensed in Texas assesses the designated resident for the DME or CMWC; • request authorization to provide the DME or CMWC through the Long… [read post]
15 Jan 2010, 6:06 am
Generally, Durable Medical Equipment ("DME") suppliers are statutorily prohibited from telemarketing Medicare beneficiaries regarding furnishing a covered item. [read post]
12 Jul 2009, 10:57 pm
Based on those claims, Medicare paid the DME companies approximately $56 million. [read post]
14 Jan 2015, 7:37 am
The purpose of this contract will be to identify improper Medicare payments for durable medical equipment (DME), orthotics, prosthetics, and supplies and home health/hospice (HH/H) claims and work with CMS and the DME and HH/H MACs to adjust claims to recoup overpayments and pay underpayments. [read post]
27 Jul 2012, 2:45 pm
If you are in the business of selling medical supplies, such as wheelchairs and other durable medical equipment (DME), you may liable for charges of Medicaid or Medicare fraud if you fraudulently bill for the equipment you supply. [read post]
9 Jun 2022, 6:55 am
DME has contested the fine. [read post]
14 Aug 2010, 8:00 am
It may be necessary to contact other personnel who can access the DME and make arrangements to preserve the data. [read post]
10 Jul 2012, 4:05 pm
In late June, federal agents arrested the owner and three former employees of RGV DME, a now-closed medical equipment supplier based in Pharr, Texas. [read post]
20 May 2015, 10:23 am
CMS is hosting a Special Open Door Forum call on May 27, 2015 to discuss eliminating the Certificate of Medical Necessity (CMN) and Durable Medical Equipment (DME) Information (DIF) forms. [read post]
4 Mar 2013, 2:17 am
., Board Certified by The Florida Bar in Health Law We have recently received numerous communications from health care professionals, including physicians, physical therapists, occupational therapists, mental health counselors, durable medical equipment (DME) … Continue reading → [read post]
10 Jul 2012, 12:06 pm
CMS explained that it added the face-to-face requirement for certain DMEs because, after empirical study, billed DMEs of the above four characteristics often failed to meet coverage criteria. [read post]
10 Jul 2012, 12:06 pm
CMS explained that it added the face-to-face requirement for certain DMEs because, after empirical study, billed DMEs of the above four characteristics often failed to meet coverage criteria. [read post]
27 Jan 2020, 5:38 pm
., a manufacturer of durable medical equipment (DME) based in San Diego, California, has agreed to pay more than $37.5 million to resolve alleged False Claims Act violations for paying kickbacks to DME suppliers, sleep labs and other health care providers, the Department of Justice announced today. [read post]
20 Dec 2016, 6:33 am
” On the other hand, four out of five beneficiary advocacy groups interviewed reported that their members experienced access issues related to competitive bidding (e.g., delays in delivery of CBP-covered DME items and trouble locating contract suppliers to provide specific DME items). [read post]
15 Dec 2007, 5:00 am
Ruiz owned and operated Solair Medical Corp., another fraudulent DME company. [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]
27 Mar 2015, 9:19 am
Today CMS published a notice updating the Healthcare Common Procedure Coding System (HCPCS) codes on the Durable Medical Equipment (DME) List of “Specified Covered Items” that require a face-to-face encounter and a written order prior to delivery (although CMS still is delaying enforcement of the face-to-face examination – but not the detailed written order – requirement). [read post]
