“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
Goethe...ie "Show me the Law!!!"
Tuesday, July 28, 2015
Medicare Fraud is a Never Ending Story
A most Sad issue since it is many of those in the Medical Industry that are doing it. By their fraudulent actions, many are being denied the medical care they need and/or the government debt is being increased. (Debt in America: Real Time)
OIG posts two reports and enforcement actions. As always, you can use
the links provided to go directly to the new material.
Contractors' Payments to Providers for Hospital Outpatient Dental
Services in Jurisdiction K Did Not Comply With Medicare Requirements
contractor payments to providers in Jurisdiction K (Connecticut, Maine,
Massachusetts, New Hampshire, New York, Rhode Island, and Vermont) for
hospital outpatient dental services did not comply with Medicare
requirements. Of the 100 dental services in our stratified random
sample, 85 did not comply with Medicare requirements. Using our sample
results, we estimated that Medicare contractors improperly paid
providers at least $2,276,853 for dental services provided during the
period January 1, 2011, through December 31, 2013.
Hospice of New York, LLC, Improperly Claimed Medicare Reimbursement for Some Hospice Services (A-02-13-01001) http://go.usa.gov/37peV
of New York, LLC (the Hospice), operating in New York State, claimed
Medicare reimbursement for some hospice services that did not comply
with certain Medicare requirements. Of the 100 beneficiary-months in our
random sample for which the Hospice claimed Medicare reimbursement, 79
beneficiary-months complied with Medicare requirements, but 21 did not.
We estimated that the Hospice received at least $1.3 million in improper
Owner of Detroit Home Health Care Companies Sentenced to 80 Months in Prison for Role in $12.6 Million Fraud Scheme (July 24, 2015; U.S. Department of Justice) http://go.usa.gov/3wjCE
Stockton Oncologist Pays $736,000 to Resolve False Claims Act Allegations (July 24, 2015; U.S. Attorney; Eastern District of California) http://go.usa.gov/3wjCE
Certified Obstetrician And Gynecologist Agrees To Civil Fraud
Settlement In Conjunction With Deferred Prosecution In Medicare And
Medicaid Fraud Investigation (July 24, 2015; U.S. Attorney; Eastern District of New York) http://go.usa.gov/3wjCE
Dallas County Woman Admits Defrauding Medicaid (July 24, 2015; U.S. Attorney; Northern District of Texas) http://go.usa.gov/3wjCE