Medicare Compliance & Reimbursement
Medicaid Probe Drives Supplier Out Of Business
DME suppliers should repeat this mantra: documentation, documentation, documentation. Failure to keep on top of documentation can be catastrophic, as a Brighton, MA supplier recently learned. According to Massachusetts Attorney General Tom Reilly, Leonid Kopilevich, operator of Elaine Mishel Shoe Store - a DME supplier since 1985 - agreed to settle Medicaid fraud allegations by paying more than $336,000. On top of that, Kopilevich and his mother, Elaine Mishel co-owner Rosalaya Kopilevich, were not only ousted from Medicaid in the Bay State, but also agreed never to apply to become a Medicaid provider anywhere in the U.S. The Kopileviches shut down their business July 1. The allegation centered on three key issues, according to Reilly:
Reilly claims the pair also engaged in "questionable" bulk billing - i.e., delivering a full year's supply of a product and billing Medicaid all at once. As a result of the investigation, the AG says, Massachusetts' Medicaid program now prohibits bulk billing.
A recent investigation focusing on three compliance hot spots should remind durable medical equipment suppliers they can't let up on documentation efforts for Medicaid.
Medicare Compliance & Reimbursement
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