Medicare Compliance & Reimbursement
A Few Bad Apples Ruining It For All DME Providers
DME dealer got wheelchair money - but didn't give her customers wheelchairs. Instead of delivering the wheelchairs to her customers, Merrifield allegedly provided scooters valued at $1,500.
Despite the continued crackdown on power wheelchair fraud, a few errant suppliers continue to keep investigators on high alert.
The owner of a Tulsa, OK durable medical equipment company is the latest to plead guilty to forging Certificates of Medical Necessity (CMNs). Now, Janet Merrifield must pay more than $348,000 in restitution to Medicaid, serve five months in prison, five months of home detention and three years of supervised release, according to Oklahoma Attorney General Drew Edmondson. A joint investigation by the state's Medicaid Fraud Control Unit found that Merrifield, the operator of Mid-States Medical, signed doctors' names on CMNs for electronic wheelchairs and received reimbursement of up to $5,000 from Medicaid.
Fraudster Illustrates What Not To Do
Lesson Learned: As prosecutors continue to get rid of these crooked DME dealers, tight compliance is the name of the game.
Medicare Compliance & Reimbursement
- Appeals:
Medicare Appeals Changes Coming
Strict new protocols highlight alterations.
If you're a provider who has gotten used to flexibility in [...] - Compliance:
Prove Consults With A Written Request
Safety first: Get some kind of documentation on consult request for patient record.
Last September's transmittal [...] - Compliance:
In-House Consult Forms Make Good Sense
Docs can protect practices with standard consult sheet.
Some consultants do recommend that physicians make their [...] - Physicians:
Incident-to Rule- To Be Or Not To Be?
CMS decides something's rotten in state of Transmittal 20.
Physicians who have been relying on [...] - Disease Management:
Disease Management Demo Projects In Effect
One provider set to sign up 30,000 beneficiaries.
If you are a provider frustrated by dealing [...] - Coverage:
Listen To This Good News About Cochlear Implants
Also, triple-threat drug combo will target nausea and vomiting.
Medicare expanded its coverage for cochlear implant [...] - Hospitals:
Survey- Hospitals Pay Better Than ASCs
Could Medicare save a billion by utilizing ASCs more?
Medicare pays much less for the same [...] - Medicare Advantage:
2006 MA Pay Hike Not As Steep As Past Years
... but MA plans will still get a bump
Medicare Advantage private health plans will get [...] - Medicaid:
New York Plan Could Set National Trend
State passes very fashionable Medicaid proposal.
An influential Medicaid reform plan in the Empire State could [...] - Enforcement Watch:
A Few Bad Apples Ruining It For All DME Providers
DME dealer got wheelchair money - but didn't give her customers wheelchairs.
Despite the continued [...] - Rehab:
Therapists Cheer Physician Self-Referral Scrutiny
Congressional proposals could mean more business for therapists.
Therapy providers who've been losing sleep over physician-owned [...] - Bill Watch
The following bills were introduced in the Senate: S. 708. A bill to amend title [...] - Physicians:
AMA Sounds Alarm Bells Concerning Senior Access
Organization says if Congress cuts payout, docs will cut Medicare patient loads.
Senior citizens will begin [...]
