Acting CMS Administrator Weems Announces Efforts To Reduce Medicare Fraud In Seven States

Not too long ago we had the embarrassing situation of “dead doctors” being billed so perhaps this is a step up in this direction to get a handle on what we do and do not pay for from our taxpayer dollars. Unannounced visits are a good thing in this direction as a picture is worth a 1000 words, especially in the case of post office boxes, etc. being listed as offices with no doctor in sight. On the other side, they need to get their data houses connected too. BD

The federal government has joined a lawsuit against several companies alleging that they submitted false claims to Medicare, paid illegal kickbacks and established fake durable medical equipment suppliers, Dow Jones reports. The suit involves McKesson, one of the largest suppliers of medical equipment in the U.S.; GGNSC Holdings; Golden Gate Ancillary; and Ceres Strategies.

CMS on Monday announced new efforts to detect and combat Medicare fraud committed by durable medical equipment suppliers and home health care agencies, CongressDaily reports. Under the plan, the agency will expand a recovery audit contractor program nationwide. The program ran as a three-year demonstration project in six states and recovered $900 million in overpayments (Edney, CongressDaily, 10/6). Contractors will focus on companies and individuals whose Medicare billings are higher than those submitted by the majority of providers and suppliers in a community. The contractors will be compensated based on the overpayments and underpayments they identify (Carey, CQ HealthBeat, 10/6).