Medicare Compliance & Reimbursement
PAY A BENEFICIARY, PAY THE PRICE
Mult-million-dollar fraud case keeps DME suppliers in the enforcement cross hairs. Paying patients for their Medicare information and illegally compounding nebulizer drugs has culminated in lengthy prison terms for five Floridians. Idania Arias will spend 10 years in jail, while Dr. Pedro Sarduy, Marco Burgos, Grisel Arias and Suzanne Burgos will serve out five years each for participating in what prosecutors are calling the biggest Medicare pharmaceutical fraud conspiracy ever in south Florida - purportedly a long-time hotbed of durable medical equipment-related fraud scams. According to U.S. Attorney Marcos Jimnez, the plot was masterminded by Idania Arias, and involved paying beneficiaries $50 for the use of their Medicare cards, then using the information to trump up claims for medically unnecessary nebulizer drugs. The case also involved pharmacies that compounded drugs such as albuterol to supply the conspirators with cut-price products with which to fulfill the prescriptions. Twenty-six individuals have already been convicted in connection with the $25 million scheme; the five sentenced May 21 are the "lead" defendants, Jimnez says. Lesson Learned: High-stakes cases continue to put DME suppliers in the fraud and abuse spotlight, making concerted compliance efforts all the more important for medical equipment companies.
Medicare Compliance & Reimbursement
- Medicare:
SENATE FINANCE APPROVES
After an all-day June 12 mark-up, the Senate Finance Committee approved a bill that would [...] - Hospitals:
HOSPITALS BRACE FOR NEW OUTLIER POLICIES
Only a small number of hospitals will have to go through the onerous process of [...] - Long-Term Care:
LONG-TERM CARE PROPOSAL COULD PROVIDE SHORT-TERM HELP
But a new CMS SNF payment policy cut both ways.
Skilled nursing facilities would get a [...] - Enforcement :
AN EVEN TOUGHER WHISTLEBLOWER LAW?
A move is afoot to up the stakes yet again in the ongoing campaign against [...] - Ambulance:
KNOW WHO TO BILL WHEN TRANSPORTING HOSPITALIZED PATIENTS
The HHS Office of Inspector General has its eye on ambulance providers who submit Medicaid [...] - Medicare+Choice:
WATERED-DOWN Rx PROPOSAL STILL STRONG ENOUGH TO HELP M+COs
Medicare+Choice plans that have been holding on in hopes of being saved by a prescription [...] - Fraud & Abuse:
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk [...] - People:
GAO LETS LOOSE PARTING BLOW AGAINST EX-OIG CHIEF
The General Accounting Office gave former HHS Office of Inspector General chief Janet Rehnquist a [...] - Quality of Care:
DOLLARS FOR QUALITY
Hospitals could soon collect bonuses from Medicare for delivering high-quality care. The Centers for Medicare [...] - Labs:
SUMMER SURVEYS MAY OFFER SLIMMER CITATIONS
What Will CLIA Inspecions Look Like This Season?
Who says there ain't no cure for the [...] - Pharmaceuticals:
BALDACCI INTRODUCES REVISED MAINE Rx
Maine Governor John Baldacci has proposed a revised version of the state's Maine Rx initiative, [...] - Pharmaceuticals:
WYDEN: NIH IGNORED PATIENT, TAXPAYER COSTS FOR TAXOL
The National Institutes of Health had the authority to get a better deal for taxpayers [...] - Fraud & Abuse:
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk [...] - DME:
PAY A BENEFICIARY, PAY THE PRICE
Mult-million-dollar fraud case keeps DME suppliers in the enforcement cross hairs. Paying patients for their [...] - Bill Watch
The following bills were introduced in the House: H.R. 2423. A bill to amend title [...] - PROGRAM MEMO ROUNDUP
Starting Oct. 1, if you don't include an ICD-9-CM diagnosis code on your Part B [...] - Register Watch
The Centers for Medicare & Medicaid Services asked for comments on extension of two information [...]
