Medicare Compliance & Reimbursement

Plus: Home health false claims fraud uncovered. Fraud is fraud, no matter how old you are. That's what 88-year-old audiologist Adam John Sortini discovered when he was sentenced Dec. 11, 2009 to six months in prison to be followed by 15 months of home confinement, plus restitution of $100,000 for defrauding the Medicare program from January 1998 to January 2003, when the FBI finally raided his office in Merced, CA. Sortini visited skilled nursing facilities across Northern California and billed for hearing tests that were not reimbursable by Medicare because they were routine in nature and were performed without a referring physician's order, according to a press release from the United Stated Department of Justice (http://www.justice.gov/usao/cae/press_releases/docs/2009/12-14-09SortiniSentencing.pdf ). Also, he did not perform all the tests for which he billed Medicare and supplied forged physician referrals when asked during audits to explain his Medicare claims, the release indicates. But then [...]