I just received the following message from my Dad:
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MEDICARE FRAUD UPDATE 10: The Centers for Medicare and Medicaid
Services announced 6 OCT it is ramping up efforts to detect fraud
that costs the agency millions in fake billing for home health
services and durable medical equipment never delivered. CMS officials
said the agency is launching a national recovery audit contractor
program that will track businesses whose billing for Medicare
services trends higher. CMS also is taking additional steps in
specific states where fraud is the most rampant. "Because Medicare
pays for medical services and items without looking behind every
claim, the potential for waste, fraud and abuse is high," CMS Acting
Administrator Kerry Weems said in a statement. "By enhancing our
oversight efforts we can better ensure that Medicare dollars are
being used to pay for equipment or services that beneficiaries
actually received while protecting them and the Medicare trust fund
from unscrupulous providers and suppliers." Durable medical equipment
suppliers, who provide such equipment as oxygen supplies or power
wheelchairs, have faced increasing heat as lawmakers search for areas
of Medicare's budget to trim and Senate Republicans make fighting
Medicare fraud their major healthcare focus.
CMS estimates that $1 billion of the $10 billion it made in payments
for durable medical equipment from APR 06 to MAR 07 were improper, in
part due to fraud, according to a recent Government Accountability
Office report. Both the GAO and the Health and Human Services
inspector general have urged CMS to beef up its fraud detection
efforts on the equipment industry. Durable medical equipment
suppliers, represented by the American Association of Homecare, agree
with CMS' announcement Monday, a spokesman said. During a three-year
demonstration program in six states, the recovery audit contractors
that CMS now plans to use nationwide recovered $900 million in
overpayments. The agency also plans to verify with beneficiaries
delivery of home health services or durable medical equipment for
which Medicare was billed and keep an even closer eye on durable
medical equipment suppliers in Florida, California, Texas, Illinois,
Michigan, North Carolina and New York as well as home health agencies
in Florida. In those states, equipment suppliers' claims will be
scrutinized more closely, and CMS will make unannounced visits to
ensure the companies are in business. [Source: Congress Daily Anna
Edney article 6 Oct 08 ++]
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Ron
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Ron Carson MHS, OT
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