tci Medicare Compliance & Reimbursement - 2022 Issue Q4

Fraud And Abuse: DME, Genetic Testing Fraud Bring Big Enforcement Actions

Plus: Unnecessary therapy garners qui tam settlement. If you thought federal enforcers might slow the pace with COVID case ratcheting up and inflation wrecking providers’ bottom lines, think again. Read on for some recent enforcement highlights targeting Medicare fraud and abuse. DME, genetic testing: You should expect the feds to take notice if you defraud Medicare for millions in false and fraudulent claims for medically unnecessary durable medical equipment (DME) and cancer genetic testing, one physician discovered. Texas-based physician, Daniel Canchola, MD, pleaded guilty for his part in the $54 million scam. The doctor signed orders electronically for DME...

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