Compliance News Roundup: Outpatient Physical Therapy

1. Healthcare News: Captured Fugitive – “On March 23, 2018, fugitive Antonio Quevedo-Ledo was detained by U.S. Customs and Border Protection at Miami International Airport after arriving from a flight from Cuba. He was indicted in January 2010 on charges of Healthcare Fraud and Forfeiture. Quevedo-Ledo owned AIC Pharmacy in Miami Florida. Investigators believe that, during a 3-week span in June 2009, Quevedo-Ledo caused the pharmacy to submit approximately $757,468 in Medicare claims for various healthcare benefits, items, and services. However, these benefits, items, and services were either not medically necessary or were not provided to Medicare beneficiaries.” Get the full scoop >>

2. Alere to Pay U.S. $33.2 Million to Settle False Claims Act Allegations Relating to Unreliable Diagnostic Testing Devices – “Massachusetts-based medical device manufacturer Alere Inc. and its subsidiary Alere San Diego (Alere) have agreed to pay the United States $33.2 million to resolve allegations that Alere caused hospitals to submit false claims to Medicare, Medicaid, and other federal healthcare programs by knowingly selling materially unreliable point-of-care diagnostic testing devices, the Justice Department announced today.” Get the full scoop >>

3. Deeper Than the Headlines: Outpatient Physical Therapy – If your organization provides outpatient physical therapy services, it’s probably a good idea to become familiar with the OIG’s latest work in this area. That’s why, this week we’re going to dive deep into Outpatient Physical Therapy. In March of 2018, the OIG posted a report entitled, “Many Medicare Claims For Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements.” The OIG reviewed 300 claims in a stratified random sample. They found that 61% of Medicare claims for outpatient physical therapy services did not comply with Medicare medical necessity, coding, or documentation requirements… Get the full scoop >>