tci Medicare Compliance & Reimbursement - 2009 Issue 4

FRAUD & ABUSE: Suppliers Take More Heat For Dead Doc Billing

Medicare paid $34 million for claims with faulty doc numbers. Physicians' NPI numbers will give you a much bigger billing headache if a federal watchdog agency gets its way. In 2007, durable medical equipment suppliers received $34 million in Medicare payments based on inactive or invalid physician UPINs and National Provider Identifier numbers, the HHS Office of Inspector General finds in a new report (OEI-04-08-00470). That's down from $91 million in 1999 -- but not far enough, the OIG contends.Breakdown: $27.8 million worth of claims with incorrect UPINs were inactive, meaning the practice setting they represented was...

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