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Tag: Therapy Fraud

Compliance Education for Therapy Providers in Health Care Fraud

January 12, 2014 0 Comments
Compliance Education for Therapy Providers in Health Care Fraud

Rehab Compliance Education Series – Compliance education is one of the essential elements of an effective compliance program for providers. Providers under scrutiny by one of the CMS program integrity contractors with adverse findings often find themselves wishing their compliance education had been more robust.  The Office of the Inspector General of the Department of […]

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OIG: Spectrum Rehab Overbills Medicare Program $3.1 Million

June 26, 2013 1 Comment
OIG: Spectrum Rehab Overbills Medicare Program $3.1 Million

According to a report issued by the Office of the Inspector General Spectrum Rehab LLC of New Jersey claimed Medicare reimbursement for outpatient physical and occupational therapy services that did not comply with certain Medicare requirements. The OIG random sample incuded 100 claims from a 2 year timeframe.  According to the OIG report, Spectrum improperly claimed Medicare reimbursement for […]

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CMS Announces New Program Integrity Initiatives: More Recoupment Efforts Will be Forthcoming

November 15, 2011 0 Comments
CMS Announces New Program Integrity Initiatives:  More Recoupment Efforts Will be Forthcoming

CMS announced today that  effective January 1, 2012 they will conduct demonstration projects designed to strengthen Medicare by aiming at eliminating fraud, waste, and abuse.   Three programs were announced:  Recovery Audit Prepayment Review: The Recovery Audit Prepayment Review demonstration will allow Medicare Recovery Auditors (RACs) to review claims before they are paid to ensure that the […]

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Senate Finance Report: Gaming of Medicare by For-Profit Home Health Companies

October 3, 2011 0 Comments
Senate Finance Report:  Gaming of Medicare by For-Profit Home Health Companies

The Senate Committe on Finance release a report today showing that home health companies intentionally increased frequency of home health therapy visits to manipulate Medicare reimbursement rates.  Senate Finance Committee Chairman Max Baucus (D-Mont.) and senior Finance Committee Member Chuck Grassley (R-Iowa) released this report showing tactics used by major for-profit home health companies to game […]

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Compliance Update for Rehab Podcast Now Available

September 27, 2011 0 Comments
Compliance Update for Rehab Podcast Now Available

The third podcast in an annual series with Rehab Management has been posted.  Compliance Update for Rehab Clinics and Practitioners.  This year the podcast contains important update information as a result of the Patient Protection and Affordable Act as well as the impact of other regulatory initiatives to combat fraud and abuse in the Medicare […]

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Webinar on Fraud & Abuse Initiative Targeting Therapy Provider is Now Archieved

August 31, 2011 0 Comments
Webinar on Fraud & Abuse Initiative Targeting Therapy Provider is Now Archieved

The webinar archive file in now available through Advance for Physical Therapy & Rehab Medicine.   After creating a login account via Advance, you will be able to download a copy of the handout for the presentation.  This webinar was a follow up to and earlier webinar in March: Risky Business:  Medicare Compliance for Outpatient Rehab […]

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Webinar: Medicare Fraud and Abuse Initiatives Targeting Therapy Providers

August 18, 2011 0 Comments
Webinar: Medicare Fraud and Abuse Initiatives Targeting Therapy Providers

Join me for a webinar on August 23rd on increased Medicare fraud & abuse initiatives targeting therapy providers.  Lynn McGivern, Chief Compliance Officer at ATI Physical Therapy will join me as you hear about these new initiatives, why therapy providers are being targeting and how to mitigate the risk for your practice.  The webinar is […]

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CERT Errors Continue to Highlight Physical Therapy

August 18, 2011 0 Comments
CERT Errors Continue to Highlight Physical Therapy

The Comprehensive Error Rate Testing (CERT) Program continues to highlight errors in physical therapy billing as evidenced by the 2nd Quarter Report posted by Wisconsin Physician Services (WPS), the Legacy Part B provider in MInnesota, Illinois, Wisconsin and Michigan.  The most recent reports continues to highlight the fact that therapy minutes (as documented in the […]

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CMS Releases 2nd Comparative Billing Report on Physical Therapy

August 9, 2011 0 Comments
CMS Releases 2nd Comparative Billing Report on Physical Therapy

CMS released a national provider Comparative Billing Report (CBR) regarding private practice physical therapists who practice in the outpatient setting and bill Medicare with modifier KX (for therapy beyond the cap). This CBR is similar to the original study distributed last summer except this current study focuses on 2010 billing data and is being sent to 5000 additional or different […]

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A Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse

February 15, 2011 0 Comments
A Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse

CMS uploaded a new You Tube video of their previously released slide presentation to new physician on avoiding Medicare and Medicaid Fraud and Abuse.  While specifically designed for new physicians there are good compliance references for rehab providers.  Listen and enjoy!

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