A Pennsylvania manufacturer that specializes in sleep apnea masks has agreed to pay $34.8 million to settle allegations it offered free services to durable medical equipment suppliers to incentivize increased equipment sales, according to the Department of Justice.
In 2012, Olympus warned European hospitals that one of its medical scopes was harboring dangerous bacteria. More than two years later, U.S. hospitals reported infectious outbreaks linked to the same scope that ultimate infected more than 250 people between 2012 and 2015. The patient safety debacle left many wondering how this could happen. A massive kickback scheme that predated the outbreak offers some belated clues, revealing an eroded corporate culture that valued profits over compliance, regardless of the repercussions.
A new federal rule that requires prior authorization for certain durable medical equipment could lead to extra paperwork for physicians and frustration for patients, according to an article from Family Practice News.
The Centers for Medicare & Medicaid Services has issued a final rule specific to the ordering of durable medical equipment such as hospital beds, prosthetics, orthotics and other supplies.
Responding to "longstanding concerns" about improper payments tied to durable medical equipment (DME), the federal government issued a finale rule Tuesday aimed at reducing fraud, waste and abuse within an industry known for questionable billing practices.
Medicare's proposed updates to Local Coverage Determiniations for lower limb prosthetics casts an impossibly wide net in an attempt to elminate the pervasive fraud among durable medical equipment providers. But in doing so, the government is bound to catch a number of legitimate beneficieries who rely on prosthetics for any number of reasons. A more reasoned approach would be to screen providers and monitoring claims in order to parse out the true fraudsters.
States such as New Jersey have already used pre-authorization programs to crack down on fraud schemes tied to non-emergency ambulance transportation, and now the Centers for Medicare & Medicaid Servics is applying the same program to power wheelchairs.
High rates of healthcare fraud arrests among Cuban born immigrants reveal problematic fraud shemes in South Florida. Although those statistics are unexpectedly high, they aren't shocking considering that healthcare fraud has been endemic throughout South Florida for many years, said Robert Nicholson, Esq., a managing partner with Nicholson & Eastin, LLP in Fort Lauderdale, Florida in an exclusive interview with FierceHealthPayer: Antifraud.
The FBI has raided the medical supply company Med-Care Diabetes & Medical Supplies Inc.--a firm that garnered national attention because of ties to an infamous fraudster who helped inspire the blockbuster movie "The Wolf of Wall Street."
A federal jury in Los Angeles convicted a southern California man for his role in a $1.5 million durable medical equipment (DME)-related fraud scheme, the Department of Justice announced Monday.