Posts tagged with: "durable-medical-equipment-fraud"
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3 May 2012, 7:14 am
In Miami, Florida, 59 individuals, including 3 nurses and 2 therapists, were charged with submitting $137 million in false billing for home health care, mental health services, occupational and physical therapy, and durable medical equipment. [read post]
27 Dec 2012, 8:30 am
Leider, J.D.The federal government has several tools in its toolbox to combat Medicare fraud. [read post]
20 May 2009, 12:09 pm
While the initial focus will be on suppliers of Durable Medical Equipment with home health agencies likely to follow, all providers who significantly rely upon Medicare and Medicaid funding located in these targeted geographic areas are well advised to review their practices for compliance with Medicare and Medicaid regulations and policies. [read post]
4 Oct 2012, 10:30 pm
The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home health care, mental health services, psychotherapy, physical and occupational therapy, durable medical equipment (DME) and ambulance services. [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]
4 May 2015, 8:00 am
A 2012 report by the Government Accountability Office found the defendants in about 25% of Medicare fraud criminal prosecutions were medical facilities (clinics, practices, and other medical centers) and their affiliates, 16% were suppliers of durable medical equipment, and 3% were beneficiaries. [read post]
14 Mar 2011, 10:07 am
The most common fraudulent acts are: - The billing of late charges by a hospital - False durable medical equipment claims (DME) - Behavioral health fraud - Medical identity theft - Billing for services, procedures and/or supplies that were never provided or performed - The condition treated or the diagnosis made - The charges for services, procedures and/or supplies provided or performed - The deliberate performance of… [read post]
16 Jul 2010, 4:53 am
The charges are based on a variety of fraud schemes, including physical therapy and occupational therapy schemes, home health care schemes, HIV infusion fraud schemes and durable medical equipment (DME) schemes. [read post]
22 Jan 2010, 9:05 am
Perez, is presumed innocent until and unless proven guilty.According to the Indictment, the fraud involved durable medical equipment (DME), which is equipment that can be used in the home on a repeated basis for a medical purpose. [read post]
15 Nov 2015, 3:04 pm
While not spelled out, where there are mobile shockwave treatments it may have been indicated that there was a lease for the equipment and location. [read post]
23 Apr 2009, 1:58 pm
The enforcement has typically focused on the durable medical equipment (DME) providers. [read post]
15 Dec 2007, 5:00 am
Collectively, the five defendants filed fraudulent claims with Medicare for over $28.6 million worth of unnecessary durable medical equipment (DME) and infusion therapy. [read post]
22 May 2014, 4:21 pm
CMS has just released a proposed rule that would require Medicare prior authorization (PA) for certain Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items that the agency characterizes as “frequently subject to unnecessary utilization. [read post]
6 Jun 2016, 12:16 pm
While the OIG’s efforts to combat fraud and abuse cover an array of creative fraud schemes, recent trends underscored fraud in the following fields: Controlled and noncontrolled substances Home health agencies/personal care services Ambulance transportation Durable medical equipment Diagnostic radiology and laboratory testing If you have questions about this blog post, you may contact us at our Atlanta or Augusta Offices, or by email… [read post]
6 Jun 2016, 12:16 pm
While the OIG’s efforts to combat fraud and abuse cover an array of creative fraud schemes, recent trends underscored fraud in the following fields: Controlled and noncontrolled substances Home health agencies/personal care services Ambulance transportation Durable medical equipment Diagnostic radiology and laboratory testing If you have questions about this blog post, you may contact us at our Atlanta or Augusta Offices, or by email… [read post]
31 Jul 2007, 7:45 am
RodrigueThe medical necessity of durable medical equipment (“DME”) billed to the Medicare Program may have no relevance to a court’s determination of whether a DME supplier submitted claims based on fraudulent Certificates of Medical Necessity (“CMN”). [read post]
24 Feb 2023, 12:29 pm
Of that $2.2 billion, “over $1.7 billion related to matters that involved the health care industry, including drug and medical device manufacturers, durable medical equipment, home health and managed care providers, hospitals, pharmacies, hospice organizations, and physicians. [read post]
18 Apr 2012, 9:07 am
It has become all too common in the healthcare industry for durable medical equipment suppliers to market and provide medical supplies to seniors that are unnecessary and unwanted. [read post]
14 Feb 2012, 11:13 am
A prior authorization request can be completed by the ordering physician or treating practitioner and submitted to the appropriate Durable Medical Equipment Medical Administration Contractor (DME MAC) for initial decision. [read post]
29 Jan 2016, 5:30 am
In the final indictment, a San Diego chiropractor referred patients to a licensed provider of durable medical equipment, Julian Garcia. [read post]