tci Medicare Compliance & Reimbursement - 2009 Issue 9

INDUSTRY NOTES: Off-Kilter Claim Patterns for Inhalation Drugs Set Off OIG's Radar in South Florida

Plus: Another fraud contractor arrives on the scene. If you thought the OIG wasn't looking at your claims from all possible angles, it's time to think again. A new OIG report, issued on April 22, notes that although only two percent of Medicare beneficiaries live in South Florida, "this area accounted for 17 percent of Medicare's total spending for inhalation drugs in 2007."More suspicious: The OIG found that the beneficiary listed on 62 percent of the S. Florida inhalation drug claims had not had a Medicare-billed office visit or other service over the previous three-year period with the...

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