Heavy hit for Florida SNF after OIG findings
Contemporary Long-Term Care Weekly, June 14, 2007
A new review by the Office of the Inspector General (OIG) determined the services on rehabilitation claims paid to a Florida SNF were not medically necessary. The OIG determined Medicare overpayed Avante at Leesburg of Leesburg, FL, to the tune of $708,086, after completing a review of 100 claims and finding 20 "medically unnecessary or improperly billed skilled services."
The OIG recommended in its report that Avante pay back the $708,086; redouble its efforts to ensure medical necessity on future claims; check and balance its current claims; and work with its fiscal intermediary to make sure previous claims weren't overcharging as well. Avante had not publicly responded by press time, although the OIG mentioned Avante had disagreed with the OIG reviewers' findings.
Read the full report here: www.oig.hhs.gov/oas/reports/region6/60600107.pdf
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