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Home Health & Hospice Week

Industry Notes:

Therapy, Inhalation Drugs Cause More Trouble In Miami

Published on Mon Jan 03, 2011

Miami continues to have a high fraud risk profile for Medicare providers. Per-beneficiary spending on outpatient therapy in Miami-Dade County was three times the national average in 2009, the HHS Office of Inspector General notes in a new report. And Miami-Dade County had high levels of questionable billing for outpatient therapy. Plus: Medicare paid South Florida suppliers for up to 10 times more units of arformoterol than the drug's manufacturer and the three largest wholesalers distributed for sale in the area in 2008 and the first half of 2009, the OIG notes in a separate report. "Furthermore, the $62 million billed by South Florida suppliers for arformoterol during this period far exceeds the total possible sales in the area," the OIG blasts. The excessive billing for inhalation drug arformoterol began when CMS cracked down on billing for budesonide with an edit. "Nearly 30 percent of suppliers that had billed for [...]
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