Sleep testing is clearly on the Office of Inspector General’s radar. A recently released report by the agency identified nearly $17 million in questionable billing for PSG services. A lawyer analyzes the OIG’s report and provides recommendations you can implement today. In a report issued last week, the Office of…
According to the US Department of Justice, Florida-based American Sleep Medicine LLC has agreed to pay the government approximately $15,300,000 to resolve allegations that it billed Medicare and other government payors for diagnostic sleep services that were not eligible for payment. The payment settles a qui tam or False Claims…
The Office of Inspector General (“OIG“) has refused to grant a request that Boarded Sleep Physicians be permitted to dispense PAP therapy directly to their own Medicare patients. The OIG’s Semiannual Report to Congress for the period April 1, 2012 – September 30, 2012 (the “Report“) issued on November 27,…
On October 3, 2012, the OIG released its Work Plan for the FY of 2013. Throughout the week, we will be posting on various aspects of the Work Plan pertinent to our clients and our readers in the following areas: • Hospitals • Home Health Agencies • Hospices • Evaluation…
Premier Home Care, a Durable Medical Equipment company operating in Indiana and Kentucky, agreed to pay a $578,820 settlement with the United States Department of Justice and the State of Indiana in a Whistleblower action alleging violations of the False Claims Act. In 2008, a former employee filed suit against…
Late last month the United States Justice Department announced that Areté Sleep LLC, Areté Sleep Therapy LLC and Areté Holdings LLC (“Areté”) agreed to settle false claims allegations for $650,000. The prosecution contends that from November 2002 to December 2009 Areté’s medical equipment and sleep medicine facilities in Arizona and…
The 38-count indictment charged 20 individuals with various healthcare fraud, kickback and money laundering charges related to their alleged participation in a healthcare fraud scheme involving approximately $200 million in Medicare billing for mental health services. The defendants worked with and for American Therapeutic Corporation (ATC) and Medlink Professional Management…
Following upon the heels of September’s first-ever Advisory Opinion on sleep testing, the Office of Inspector General today issued the second and third installments of what appears to be the OIG’s Sleep Opinion Trilogy. These new opinions generally follow the facts of the first opinion – a third party management…
CMS published its interim final values for sleep testing yesterday, November 2, 2010, as part of Medicare’s Final Part B Physician Fee Schedule for 2011. Although the sleep code values are to be effective January 1, 2011, CMS is offering the public the opportunity to comment on these new sleep…
Because Medicare payments for sleep testing has increased from $62 million in 2001 to $235 million in 2009, the OIG will review the appropriateness of payments for such testing and the factors contributing to such a steep increase in payments. Additionally, the OIG will examine the appropriateness of Medicare payments…