No accreditation or surety bond? No problem. Here's a million bucks.

 - 
01/21/2010

I just came across yet another article on Medicare fraud. The story lead off with—wait for it—a fake DME provider in Miami.

An article by Mark Potter on MSNBC.com reads:

"After knocking on the door, calling the office number and peering through the mail slot, they found no one inside the 250-square-foot facility, which had only a desk and a few medical supplies on shelves along the wall. "The equipment on the wall certainly wouldn't justify one percent of what's billed to Medicare," said FBI Agent Brian Waterman."

Hmmm. Was there a framed accreditation certificate hanging on the wall? A copy of the company's surety bond on file so that it could bill Medicare for more than $1 million in fake claims?

Why are legitimate providers doing all that again? To prevent fraud, supposedly.

Even better, Medicare often pays dead docs for services rendered. But, if you are a legitimate provider with an order in hand from a long-time trusted referral source, you'd better not contact the patient for whom it was prescribed. At least, that's what the OIG says.


Theresa Flaherty

#HME News

Comments

ABSOLUTELY, but this message always seems to fall on deaf ears. When will the start taking "legitimate" providers advice and ask for all that information first and then issue a billing provider number. MAKES NO SENSE>

Was this recent? Just last week I challenged the NSC Liason (who spoke at FAMES meeting) that the NSC has failed to be the 'police' and has allowed fraud to continue. The NSC is a private contractor - owned by Palmetto, owned by Blue Cross, Why doesn't CMS hold them liable when they approve a "provider" and that "provider" is a fraud.

John, the story ran Jan. 11.