Medicare Audit | The Health Law Firm Blog

Have You Received a Notice of Termination of Your Medicare Provider Number?

By Danielle M. Murray, J.D.

Have you received a notice of termination of your Medicare provider number? Medicare has been revoking the Medicare provider numbers of many different Medicare providers including psychologists and other mental health providers, based on returned mail sent to old addresses which have not been updated or based on inspection team site visits to old addresses.

Often the termination is retroactive to a much earlier date the change or move may have been determined to have occurred. Even if the mailing address is correct or was changed, the physical address of the business must have been updated, as well. It is usually an incorrect or old physical […]

By The Health Law Firm|2024-03-14T10:01:05-04:00May 15, 2018|Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|

Medicare and Medicaid Audits of Psychologists and Other Mental Health Professionals – Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Over the past year I have observed an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals.

I have recently seen a number of audits initiated against psychologists and mental health professionals who treat assisted living facility (ALF) and skilled nursing facility (SNF) residents. Most often these are audits by the Medicare Administrative Contractor (MAC), because this area of medical practice has been identified as one fraught with fraud and abuse. Sometimes these are only “probe” audits, initial audits requesting one (1) to five […]

By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Medicaid audit, Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|

Medicare Fraud Lands More Than 30 Suspects Behind Bars in South Florida

By Dr. Thu Pham, O.D., Law Clerk

On October 4, 2012, federal authorities arrested 33 suspects in South Florida for allegedly filing fraudulent Medicare claims totaling $205 million. Payment of bribes and kickbacks, as well as payments to patient recruiters were an issue in this investigation.

To read the entire article from the Miami Herald, click here.

Feds Focus on Crackdown of Medicare Fraud Nationwide.

These arrests are part of a nationwide initiative to crack down on theft committed by individuals against Medicare. Peter Budetti, the Medicare anti-fraud czar states that the goal is to catch the fraud before the fraudsters “can successfully bill Medicare.” Previously, fraud was caught only after the funds were disbursed and spent.

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By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Clinical Social Worker, Intern, Marital and Family Therapist, Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|