Suppliers get good report for hurricane service, however. Suppliers shouldn't expect fraud and abuse scrutiny to let up after the HHS Office of Inspector General's latest report to Congress. In its December semiannual report to Congress, the OIG includes a laundry list of durable medical equipment suppliers brought up on fraud charges in Florida, Texas, and California. Case #1: In Florida, an Administrative Law Judge upheld the OIG's penalty against a Clear-water, Fla.-based DME supplier. The ALJ affirmed the OIG's imposition of a $100,000 civil money pen-alty, a $42,220 assessment, and a seven-year exclusion against Cary Frounfelter and Kast Orthotics and Prosthetics Inc., the OIG says in the report. Frounfelter and Kast falsely claimed they provided custom-made orthotic devices after beneficiaries had been discharged from HealthSouth Rehabilitation Hospital in Largo, Fla., or within a 48-hour window prior to discharge, the OIG alleges. They then illegally billed the devices to Medicare Part B. Frounfelter and Kast struck a "corrupt bargain" with HealthSouth, the OIG claims in the report. Case #2: In Texas, wheelchair suppliers Pi-us Ekiko and Harold Iyalla paid two doctors for false wheelchair certifications and billed Medicare for pricier wheelchairs when really furnishing less expensive scooters. The DME owners, a patient recruiter, and the two physicians were sentenced to more than 380 months in prison and ordered to pay more than $18 million in restitution, the OIG says. Case #3: The Medicare Fraud Strike Force in South Florida and in California is using "real-time analysis of Medicare billing data, as well as findings from investigations, in its ongoing efforts to identify, investigate, and prosecute individuals and companies that have committed DME fraud," the OIG says. The South Florida Initiative has resulted in 50 convictions and $68.9 million in "investigative receivables," the OIG says. The OIG also noted its recent reports on the DME sector, including its high-profile slam of DME CERT numbers (see Eli's HCW, Vol. XVII, No. 31, p. 242) and a report that found disaster-related DME claims for 2005 hurricane victims all checked out. The report is online at
www.oig.hhs.gov/publications/docs/semiannual/2008/semiannual_fall2008.pdf. • Home health agencies and hospices got a pass in the OIG's latest report to Congress. The semiannual report contained a recounting of recent OIG reports on duplicate HHA supplies, survey deficiencies (see Eli's HCW, Vol. XVII, No. 29, p. 226), and hospice respite care (see Eli's HCW, Vol. XVII, No. 14, p. 110). But the OIG didn't single out any HHA or hospice enforcement cases to highlight. • Home care providers that pay staff based on the IRS's mileage rate may save some money in the new year. The Internal Revenue Service has lowered its rate to 55 cents per mile, down from the current 58.5 cents. [...]
