Tariq Hafeez, Esq
Home healthcare companies aren’t
the only ones overbilling Medicare –
nursing homes are at it as well.
According to a report by the staff of the Inspector General of the
Department of Health and Human Services, a review of nursing home Medicare
bills found that about one-fourth of them were incorrect.
This adds around $1.5 billion in
annual costs to the Medicare program, according to the report.
Much of the incorrect billing
involves upcoding, a common scheme where the facility submits bills to Medicare
for more intensive services than actually performed to receive a higher
reimbursement. Additionally, some
facilities provide treatments to patients that are inappropriate or
unnecessary.
“What makes this report stand out
is the sheer amount of dollars inappropriately spent,” said Jodi Nudelman, New
York Inspector General who oversaw the study.
These companies are “billing for therapy that they don’t provide or
which the patient doesn’t need.”
Medicare accounted for 13.5% of
Federal spending last year – and that percentage is expected to grow. With estimates labeling 30% of U.S. medical
spending as “unnecessary,” cutting fraud, waste, and abuse is a key part of
reducing Medicare spending - $3.7 billion has been recovered in the past 3
years.
The OIG
has said that Medicare has made several significant changes but that more needs
to be done to reduce inappropriate payments.
This systematic overbilling at the expense of taxpayers is unacceptable.
If you have questions or have
witnessed a nursing home or other provider committing Medicare fraud, contact
the experienced fraud team at Fausone Bohn, LLP. Call Tariq Hafeez or Breeda O’Leary at (248)
380-0000 or visit our website at www.MichiganFraudLawyer.com.
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