Tag: Abuse
CMS 'locks door to vault'
September 6, 2019HME News Staff
WASHINGTON - CMS has issued a final rule that creates several new revocation and denial authorities to bolster the agency's efforts to stop waste, fraud and abuse in Medicare, Medicaid and CHIP.
The Program Integrity Enhancements to the Provider Enrollment Process, CMS-6058-FC, contains a new “affiliations” authority that allows CMS to identify individuals and organizations that pose an undue risk of fraud, waste and abuse based on their relationships with other previously sanctioned...
Allstate Insurance sues slew of DME entities
June 24, 2013HME News Staff
HAUPPAUGE, N.Y. - Allstate Insurance seeks to recover $6.6 million in damages for alleged medical insurance fraud from 47 New York- and Florida-based DME entities and owners, according to a press release. The complaint, filed in the U.S. District Court for the Eastern District of New York, alleges that the DME companies, including 31 retail and 16 DME wholesale companies, submitted or facilitated the submission of fraudulent and misleading bills to Allstate Insurance for reimbursement, the release...
In brief: Lawmakers make fraud recommendations, Sleep HealthCenters closes
February 1, 2013HME News Staff
WASHINGTON - A bipartisan group of six senators on Jan. 31 released recommendations aimed at curbing waste, fraud and abuse in Medicare and Medicaid. In May 2012, members of the Senate Finance Committee, led by Orrin Hatch, R-Utah, asked the healthcare community for its suggestions on how to tackle the problem and received more than 2,000 pages of suggestions in response. Those suggestions include: eliminating duplication and redundancy in anti-fraud programs, ensuring that provider enrollment policies...
Audits: An overview of abuses
August 8, 2012HME News Staff
Editor's note: This is the last (Part V ) in a series of commentaries on audits. Also read Part I, Part II, Part III and Part IV.
No matter how you look at it, the contractors are out of control. Examples include: instructions by a ZPIC to the four DME MACs to suspend payments to a supplier because the ZPIC is dissatisfied with the supplier's documentation and because the ZPIC asserts (without substantiated evidence) that the supplier is violating the telephone solicitation statute; placement...
Respiratory rocker
February 20, 2008Mike Moran
Tune in tonight to see Amanda Overmyer, a 23-year-old respiratory therapy nurse, compete on American Idol. The show's judges named Overmyer as one of their final 24 contestants last week. Overmyer, 23, worked days at Lincare’s Kokomo, Ind., branch before wowing Randy Jackson, Paula Abdul and Simon Cowell with her grounded personality and Janis Joplin-esque voice, first in Atlanta, where she auditioned, then in Hollywood. Jackson dubbed Overmyer, who rides a Harley-Davidson motorcycle, the “Rock...