Clouds of scandal mass over Miami

Thursday, September 30, 2004

MIAMI - The inklings of another eye-popping HME industry scandal are brewing again, this time in Dade County, (Miami) Fla., where a number of doctors have sent to CMS an affidavit that declares they did not prescribe medical equipment delivered by about 50 different suppliers.

As a result, CMS has suspended payments to hundreds of suppliers in South Florida, according to Javier Talamo, an attorney at Hialeah, Fla.-based Kravitz & Talamo, who is representing 30 of those suppliers.

Talamo has countered allegations of wrong-doing by his suppliers with signed prescriptions, signed CMNs, delivery tickets and affidavits by patients who state that they did indeed receive prescriptions from their physicians for DME services provided.

“My concern is that if Medicare takes too long in responding to the rebuttals and evaluating the evidence we are sending, our clients will go out of business,” he said.

CMS had not confirmed receipt of the physician’s affidavit by the time HME News went to press, despite repeated calls for information.

The situation, however, is creating a buzz among suppliers in Dade and Broward counties.

“Providers are saying these doctors have signed the CMNs and the doctors are saying they did not,” said one Miami area supplier.

Talamo traces the source of the physician’s affidavit and the suspensions to a CMS investigation into over-utilization. He said CMS is seeking a $450,000 over-payment from one of his clients. He believes other attorneys are representing clients from whom CMS is trying to recoup much more.

“Their [CMS] investigation seems to be pretty thorough,” said Talamo. “Will there be fraud found? I believe there will be. My concern is that we extract the innocent people from the process.”