20 surtidores portables de la radiografía demuestran patrones “cuestionables” de la facturación

por Brendon Nafziger, DOTmed News Associate Editor | December 28, 2011

Of the 352 suppliers examined, about 20 aroused OIG's suspicions. Unsurprisingly, perhaps, over half of the questionable suppliers were located in and around Miami, an area known for its Medicare shenanigans. To give an example of the kind of behavior that stood out, the OIG said for the most suspicious supplier, services ordered by non-doctors accounted for almost one-third of its charges. For other providers, this only accounted for a median 1 percent, the OIG said.

Recommendations

OIG's five recommendations to CMS are (from the OIG's release):

1) Take appropriate action on portable x-ray suppliers referred by OIG,

(2) Establish a process to periodically identify portable x-ray suppliers that merit greater scrutiny and follow up as appropriate,

(3) Determine what portion of the $12.8 million it paid for return trips in 2009 actually reimbursed suppliers for incorrectly billed transportation component claims and collect any overpayments,

(4) Collect the $6.6 million in overpayments it made for portable x-ray services rendered in 2009 that were ordered by non-physicians, and

(5) Implement procedures to ensure that it pays for portable x-ray services only when they are ordered by a physician and establish appropriate controls.


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