Data transparency, enhanced provider screening software and additional site visits will serve as key components of the federal government's upgraded approach to fraud detection and prevention, outlined in two new programs announced by the Centers for Medicare & Medicaid Services last week.
Medicare spent more than $30 million during the first half of 2012 on ambulance transports for patients that appear to be ghosts on paper, according to a new report released by the Office of Inspector General Tuesday.
Although there has been a rash of ambulance fraud activity over the last several months, that has been an area of concern at the federal level for several years, Sean McKenna, a partner at Haynes and Boon LLP, said in an exclusive interview with FierceHealthPayer: AntiFraud.
One ambulance company and four hospitals in Jacksonville, Florida have opted to settle a lawsuit brought by the government in 2011 and unsealed just a few weeks ago, according to the Florida Times-Union. The settlement leaves out an additional ambulance company that is now facing renewed false claims charges from the feds.
A Centers for Medicare & Medicaid Services preauthorization program designed to weed out fraud and abuse tied to non-emergency ambulance services in three states may be doing more harm than good.
Ambulance fraud contributes to as much as $350 million in fraudulent payments each year. This week, some of those fraudulent schemes were exposed--and the perpetrators face harsh sentences.
Ambulance services contribute to as much as $350 million in fraudulent Medicare billing every year, often transporting healthy patients or double billing for two patients at one time, according to ABC News.
A new ambulance service in Denver relies on "mobile care units" rather than full ambulances to treat patients in need of emergency care, according to Kaiser Health News.
A pair of editorials last week took up the issue of Medicare and Medicaid fraud, waste and abuse, signifying these problems are becoming a greater focus of public attention and debate.
Many private New York City hospitals anticipate a stoppage of emergency ambulance services because of an initiative authorized by Mayor Michael Bloomberg to charge hospitals for using such services.