Category Archives: compliance

New HHS OIG Work Plan – Same Old Stuff for Ambulance Services

The Office of the Inspector General for the Department of Health and Human Services issued the FY 2013 Work Plan today.  The Work Plan only has one specific reference to Ambulance Services; basically it is a repeat of last year's offering: Ambulances—Compliance With Medical Necessity and Level-of-Transport Requirements We will examine Medicare claims ...

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I’ve Received a Subpoena from the Feds . . . Now What? Part 2

Obviously today is not Thursday . . . but I am back today with the follow-up post. In Part 1, I discussed the initial steps if you get a subpoena from a government agency.  Today, what are your obligations if you received a subpoena? First, let your attorney (OK, if you did not get that ...

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I’ve Received a Subpoena from the Feds . . . Now What?

Based on the recent activities of the HEAT strike teams in Texas (see here, here and here) , I would anticipate that many ambulance and other small healthcare providers may be getting subpoenas in the near future.  What should you do if you receive a subpoena from any government agency? This should ...

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CMS temporarily holding payments after January 1

The Center for Medicare Services (CMS) sent out an email to the Ambulance listserve yesterday stating that they were instructing the Medicare Administrative Contractors (MAC) to hold payments pending an update to provisions of the Social Security Act that have increased payments for ambulance services.  The current law expires December 31st and the update was ...

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Houston Doctors Indicted in Medicare Fraud Sceme – Can the Ambulance Services Be Far Behind

On Wednesday, two physicians and the owner of an assisted living facility in Houston were arrested on charges involving Medicare Fraud.  These arrests are related to the recent series of articles in the Houston Chronicle documenting large volumes of Medicare payments going to Ambulance services who transport mental health patients from assisted living facilities and ...

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City of Dallas Pays Nearly $2.5 Million to Settle Medicare/Medicaid Fraud Claim

Following the jump is a press release from the United States Department of Health and Human Services and Department of Justice regarding claims of upcoding by the Dallas Fire Department for Medicare and Medicaid claims.  I highlight this to note that it is not only the non-emergency ambulance services transporting dialysis patients that are paying ...

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Trailblazer Posts Notice Regarding Ambulance Dialysis Transport

Today, Trailblazer issued a notice the the ambulance supplier community regarding transports to and from dialysis.  Basically, Trailblazer is stating that based on alleged over utilization of ambulance transportation services for a residence to dialysis center transport (RJ and JR modifiers), they will pay the first 12 claims of the year without documentation.  After that, ...

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Medicare Audits Biting Houston Area Ambulance Companies Where It Hurts – In the Bottom Line

I have previously posted about the travails of one Houston ambulance service owner who had taken his complaints about the treatment of dialysis patients to the media.  Apparently, the initial reports were only the beginning - I don't watch the local Fox station, so I missed the follow up of the ...

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New Compliance and Regulatory Blog

OMG, My friend, David Douglass is blogging!  David is the current vice-chair of the American Bar Association Health Law Section and a partner and practice group chair for Government Enforcement/Compliance for Shook, Hardy & Bacon in Washington DC.  And he has done alot of other cool things I am still finding out about ...

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