Health Information Compliance Alert
Fraudulent Claims Result in Aggravated Identity Theft Conviction
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Abdul Waheed Alex Shittu, the owner of S & S Medical Supply Etc. located in Stafford, Texas, "pleaded guilty to one count of conspiracy to commit health care fraud and one count of aggravated identity theft," according to a Nov. 14 Department of Justice press release.
Not only did Shittu recruit people to procure physician orders (some of which were forged) for Medicaid and Medicare beneficiaries whom the respective physicians had not seen -- most of the orders he billed were not even delivered since the benes concerned did not need or want them.
"Between Dec. 1, 2008, and Sept. 30, 2009, Shittu submitted approximately $1,154,025 in fraudulent claims to Medicare and Medicaid and received $597,865.19 for those claims... Shittu faces up to 10 years in prison and a $250,000 fine as well as an additional two-year-term of imprisonment for aggravated identity theft which must be served consecutively to any other term imposed," the release said.
New Year Brings Double Duty For Hospice Quality Data Reporting
January will be a busy month for hospices, quality reporting-wise. The hospice quality reporting program is switching to a calendar year system for data collection starting in the new year, the Centers for Medicare & Medicaid Services points out on its website.
"This means that in January 2013 hospices will be doing two things: submitting data collected for the FY2014 payment determination AND collecting data for FY2015 payment determination," CMS explains. Don’t mix up your two activities, or you may risk losing Medicare reimbursement.
Hospices will collect data that affects their 2014 payment rates from Oct. 1 to Dec. 31 this year, and submit the QAPI structural measure data by Jan. 31 and the pain measure data by April 1. Hospices will collect data that affects their 2015 payment rates from Jan. 1 to Dec. 31, 2013.
More information is online at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Spotlight.html.
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