HHS Targets Billing Fraud for Wheelchairs, Other Equipment in Miami, Los Angeles

Fraudulent suppliers of durable medical equipment, prosthetics, and orthotics are in the sights of the U.S. Department of Health and Human Services, with HHS Secretary Mike Leavitt saying July 3 that a two-year effort will begin to target fraudulent billing that victimizes Medicare beneficiaries. The deceptive companies frequently operate in Miami and Los Angeles, with South Florida and Southern California being the target areas for the effort, Leavitt said.

HHS is working with the Department of Justice via a Medicare Fraud Strike Force. So far, 56 people have been charged in the Southern District of Florida with fraudulently billing Medicare for more than $258 million; 634 supplier billing numbers were revoked; and through this, Medicare has saved a projected $317 million. Products being billed at higher-than-normal rates are motorized wheelchairs; nebulizers, aerosol medications, artificial limbs, and wound therapy treatments. In the Los Angeles area last year, investigations of suppliers resulted in 770 having their billing privileges revoked.

This latest effort will include letters sent to suppliers asking that they resubmit applications to be a qualified Medicare supplier. Those who fail to reapply within 30 days, fail to report a change in ownership or address, or fail to report having owners, partners, directors, or managing employees who have committed a felony within the past 10 years will have their billing privileges revoked. "The concept is straightforward and will be effective," CMS Acting Administrator Leslie Norwalk said. "Enhancing our review of these suppliers will go a long way to ferret out those who do not meet the needs of beneficiaries and the promises of Medicare. CMS hopes to expand this effort nationwide."

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