Supplier excluded from Medicare. A man has pleaded guilty to violating anti-kickback laws after being nabbed by an undercover federal operation.
Under "Operation Headwaters," the feds have reeled in 10 guilty plea convictions and more than $600 million from providers and manufacturers in the enteral nutrition business. The Federal Bureau of Investigations and other federal agents set up "Southern Medical Distributors" in 2000 as part of a sting operation to catch fraudulent suppliers in an industry-wide probe.
In the latest case, Brian Denny pleaded guilty Friday to the felony charge in U.S. District Court in East St. Louis, according to the Associated Press. Prosecutors allege Denny defrauded Medicare by using false, misleading and fraudulent documents to conceal and misrepresent the purchase prices of feeding tubes, pumps and liquid food, AP says.
Denny agreed to be excluded from participation with Medicare for 10 years, and he has agreed to help with the prosecution of others, reports the Belleville News-Democrat. He also faces up to five years imprisonment and a $25,000 fine. The Centers for Medicare & Medicaid Services has held steady on its deadline for requiring hospitals to publish their home care referral statistics. Unfortunately, that deadline was already a ways off.
In its June 2004 semiannual regulatory agenda, CMS pushed back the date for a final rule regarding the statistics to November 2005 (see Eli's HCW, Vol. XIII, No. 25, p. 194). In its December agenda, CMS maintains that date.
Experts say they wouldn't be surprised if the date gets pushed back even further in the next agenda. However, if the final rule isn't published by Nov. 22, it will exceed the new three-year publication time limit and will have to be re-proposed, CMS notes.
Home health agencies hope making hospitals' referral statistics public will discourage hospitals from steering patients to their own HHAs or other agencies. Home care providers won't have to wrestle with new diagnosis codes this April. Although the ICD-9 committee now has the ability to revise codes every six months, there were no requests for April updates, CMS says on its coding Web site. "All those requesting new or revised codes elected to have the new codes implemented on October 1, 2005," CMS notes. The competitive bidding Program Advis-ory and Oversight Committee will face a host of topics in its next meeting, slated for Feb. 28 - March 2. Payment issues, considerations for small suppliers, data collection and quality standards are all on the agenda recently posted at
www.cms.hhs.gov/suppliers/dmepos/ compbid/tentative_topics.pdf. Interested parties must register to attend the meeting by Feb. 18. The Joint Commission on Accreditation of Healthcare Organizations is revamping its medical abbreviation rules. JCAHO convened a summit on errors caused by misused abbreviations, which was [...]
