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The latest growl from the Medicare watchdog is directed toward possible fraud by physicians approving expenses for home care services. Consider yourself warned.
The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) is issuing a special warning to physicians that they should authorize only necessary medical equipment, supplies, and services for Medicare beneficiaries. Inspector General June Gibbs Brown issued the Special Fraud Alert recently, saying the government was concerned about physicians inappropriately ordering equipment, supplies, and services for Medicare patients. The alert cautions physicians not to order items for patients as a courtesy without first determining medical necessity. The alert also warns against signing false or misleading medical certifications and/or accepting any form of kickbacks for signing off on Medicare items and services.
"A physician is not liable for erroneous claims due to mistakes, inadvertence, or simple negligence," Brown said in a press briefing. "However, knowingly signing a false or misleading certification or signing with reckless disregard for the truth can lead to serious criminal, civil, and administrative penalties."
The Fraud Alert notes that any orders for durable medical equipment or other supplies for Medicare beneficiaries must include this information: beneficiary’s name and address, physician’s signature, date of the order or prescription, description of items needed, start date, diagnosis, and a realistic estimate of the length of time the medical equipment will be needed by the patient. Drug prescriptions require the same information.
The warning was prompted by recent data in an OIG report showing that 40% of home health claims were improper.