Florida O2 inspections detect problems

Thursday, January 31, 2008

TAMPA, Fla. - Several providers of home oxygen therapy--including local branches of Lincare and Rotech--found themselves under a Medicaid microscope in December, when the Agency for Health Care Administration (ACHA) conducted inspections in the Tampa Bay area.
The review found problems that included billing for equipment that was never installed or wasn't serviced properly and unlicensed installers, said Raul Lopez, president of the Florida Association of Medical Equipment Services (FAMES).
In Florida, a respiratory therapist or registered nurse must do the initial oxygen setups for Medicaid patients. While Lopez feels most providers understand this requirement, he suspects the inspectors may have been misinterpreting the documentation.
"A lot of RTs aren't going to run around with a 100-pound liquid oxygen reservoir in the back of their cars," said Lopez. "They could have had a delivery technician deliver the units and then the RT may have trained the patient."
Florida Medicaid pays $8 million for oxygen every year. In Hillsborough and Pinellas counties, where the inspections took place, reimbursement was $845,000 for the last fiscal year.
"I think they looked at the largest expense--oxygen--coming out of an area that has relatively low expenditures in other areas," said Lopez. "I guess they felt, relative to the number of beneficiaries in the area, that was too much."
With the Medicare Strike Force continuing to garner arrests and headlines for fraud, particularly in South Florida, it comes as no surprise that the state is ramping up its own inspections, said Lopez.
"With our current deficit, they are looking at all sorts of places where we can save money or where money may have been spent in an ill manner," said Lopez.
ACHA, Florida's Medicaid program, planned to refer the companies for further review to the state Attorney General's office, the Department of Health and, possibly, to CMS.