OIG finds irregular number of claims for HIV/AIDS patients
Healthcare Auditing Weekly, September 25, 2007
The OIG found an irregular number of claims for infusion therapy for patients with HIV/AIDS in three South Florida counties, according to a September 19 OIG press release.
The counties made up 37% of nationwide services and 50% of nationwide charges between July and December 2006. However, a mere 10% of beneficiaries with HIV/AIDS reside in these counties. "Medicare continues to be highly vulnerable to fraud and abuse and immediate steps must be taken to protect the program and its beneficiaries," said Inspector General Daniel R. Levinson.
In response to these findings, CMS started a demonstration project to curb Medicare infusion billings in Southern Florida. Some aspects of the demonstration project include site visits by CMS, a more acute review for high-risk providers, and the requirement that providers resubmit applications to prove qualification.
To read this press release click here.
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