tci Medicare Compliance & Reimbursement - 2006 Issue 8

Medicare: CMS Shells Out Millions In Improper Ambulance Transport Payments

Medicare needs to better scrutinize dialysis and nonemergency transport claims.The HHS Office of Inspector General has worried for years that the Medicare ambulance transport benefit is "highly vulnerable to abuse"--and a recent analysis of 720 claims has validated those worries.One in four ambulance transport claims doesn't meet Medicare requirements, the OIG finds in a new report. Improper claims resulted in $402 million in unwarranted payments during the 2002 claim year, the OIG says. The report reviews both emergency and nonemergency ambulance transports, as well as transports to and from dialysis facilities.The OIG blames the high improper...

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