Medicare Compliance & Reimbursement

Although you may have heard much buzz about Medicare officials suspending fraudulent providers, the story goes much deeper than that, according to a new Associated Press (AP) report that was released on Oct. 16. "Regulators fighting an estimated $60 billion to $90 billion a year in Medicare fraud frequently suspend Medicare providers, then quickly reinstate them after appeals hearings that government employees don't even attend," the AP story noted. Although the quick reinstatements have been a godsend for legitimate suppliers who are wrongly accused or are accused of minor violations, they have been an unfortunate symptom of the clogged system when dealing with fake suppliers that bilk the Medicare system out of money. The problems are rooted in "poor communication between one set of contractors paid to inspect Medicare providers and alert officials to suspicious activity; a separate set of contractors that handles payments; and the agency that runs Medicare," [...]