One highlighted discussion during Oct, 3rd presidential debate was President Obama’s comments regarding his confidence in cracking down medicare fraud and the success in massive penalty and retribution.

Just one day after, The Centers for Medicare & Medicaid Services (CMS) announced that 91 people in seven cities have been charged for defrauding the government totallying $429.2 million in alleged false billing.  The charges include conspiracy to commit healthcare fraud, healthcare fraud, anti-kickback violations and money laundering (see full announcement).

Quoting from the announcement,  “Today’s enforcement actions reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billions in taxpayer dollars for personal gain,” said Attorney General Holder.  “Such activities not only siphon precious taxpayer resources, drive up health care costs, and jeopardize the strength of the Medicare program – they also disproportionately victimize the most vulnerable members of society, including elderly, disabled and impoverished Americans.”

All these are the strong indicators that necessitate all medical providers to examine and re-examine the integrity of their practices, especially in billing and claims.  Areas of the recent medicare fraud crackdown span from home health care, mental health services, occupational and physical therapy to Durable Medical Equipment (DME), including some non-traditional medical services such as chiropractors.

Many of the small to medium practices are lacking the resources to conduct effective audit in reviewing the medical billing and claim process. However,  it is recommended to proactively examine and reexamine your billing and claim practices to ensure its compliance.

If you have any questions regarding how to maintain an effective and compliant billing and claim practice, please contact us to schedule a consultation.

6 Responses to “Caution on healthcare providers on medicare billing fraud”


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