In the Feb 2000 Medicare Bulletin for the below states, this was located: Medicare Part B Medical Bulletins IL,MI,WI BILLING FOR FAILURE TO KEEP AN APPOINTMENT Fraud committed against the Medicare program may be prosecuted under various provisions of the United States Code and could result in imposition of restitution, fines, and imprisonment. In addition, there is also a range of administrative sanctions and civil monetary penalties that may be imposed. Attempts to defraud the Medicare program may take a variety of forms. According to §14001 of the Medicare Carrier' s Manual (MCM), billing the Medicare program for services or supplies that were not provided (including billing services that were not actually provided because the patients FAILED to keep their APPOINTMENTs), may be considered fraud. In its Program Integrity Manual, HCFA notes that Medicare fraud may take the form of providers or suppliers who bill Medicare for APPOINTMENTs the patient fails to keep (Chapter 3, §3.1). It is important to note that although a provider may not bill the Medicare program for “no SHOWs” because no covered service was rendered, the beneficiary may be billed. Such billing charges do not relate to any service covered under the Medicare statute so neither HCFA nor WPS may interfere with the provider's billing policy for “no SHOWs.” To avoid possible discrimination or civil rights violation, however, the provider should be certain that any “no SHOW” billing policy is
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