Home Health & Hospice Week

Fraud & Abuse:

OIG BLASTS FRAUDULENT S. FLORIDA INHALATION DRUG CLAIMS

Medicare paid five times more for two brand-name inhalation meds in Miami. Billing for budesonide has gotten tougher since last fall, but suppliers can expect even more scrutiny of claims for the inhalation drug, thanks to a new report. The HHS Office of Inspector General slams fraudulent billing for inhalation medications used in conjunction with durable medical equipment,particularly budesonide and levalbuterol, in its latest report. "Although only 2 percent of Medicare beneficiaries live in South Florida, this area accounted for 17 percent of Medicare spending on inhalation drugs in 2007," the OIG notes. Medicare paid 20 times as much for inhalation drugs in Miami as in the Chicago area, even though Chicago has nearly twice as many beneficiaries,the OIG points out. "Among beneficiaries with paid inhalation drug claims, Medicare spent approximately $4,400 per South Florida beneficiary on inhalation drugs, compared to just $815 per beneficiary on inhalation drugs in the [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more