Part B Insider (Multispecialty) Coding Alert
Department of Justice Nails Physician's Assistant And Medical Biller in Phony HIV Infusion Scam
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Plus: Next year physicians will no longer need accreditation to supply durable medical equipment. If you think the government is only cracking down on doctors, a new Department of Justice (DOJ) report shows that physicians' assistants are just as vulnerable to abuse and fraud accusations. According to a Sept. 18 DOJ press release, a Miami-based physician's assistant pleaded guilty to defrauding Medicare out of $119 million in HIV infusion reimbursement. The physician's assistant, along with several accomplices, set up fake HIV infusion clinics around South Florida. Also guilty in the scam were a medical biller, several physicians, and other personnel members. The medical biller faces 120 months in prison, while the physician's assistant faces sentencing soon. To read more about the case, go online to www.usdoj.gov/opa/pr/2008/September/08-crm-829.html. In other news ... • About a year from now, you'll have to be accredited to supply durable medical equipment under Medicare, unless you're not a traditional DME supplier. CMS "has issued an exemption for virtually every professional group except respiratory therapists, registered nurses, and pharmacists," the National Association of Independent Medical Equipment Suppliers notes in a message to members. The exempt list includes physicians, physical therapists, and other specialties. The American Podiatric Medical Association and the American Physical Therapy Association are praising CMS' exemption decision. "This is a huge victory," APTA's R. Scott Ward says in a release. "Physical therapists already provide care of the highest quality, so these unnecessary requirements would have been overly burdensome, costly and could have created obstacles for patients needing these services." NAIMES opposes the exemptions, the trade group says in a letter to CMS. "The mandatory accreditation requirement [is] a vital element in the fight against fraud, abuse, and billing errors in DME," it says. The move exempts more than 45,000 National Supplier Clearinghouse-listed suppliers from the requirements.
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Department of Justice Nails Physician's Assistant And Medical Biller in Phony HIV Infusion Scam
Plus: Next year physicians will no longer need accreditation to supply durable medical equipment.If you [...]