HCR 230 Week 6 DQ 2 - provider recognized and 73 that it...

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The improper payments, which include fraud, in Medicare pays for in wheelchairs and other home medical equipment is considerably higher than the government has predicted, according to a federal audit released yesterday. The Department of Health and Human Services found an mistake of approximately 29 percent in a section of claims paid in 2006 (The Washington post, 2008) under Medicare's multibillion-dollar long-lasting medical equipment curriculum. The Centers for Medicare and Medicaid Services had anticipated a figure of 7.5 percent, or approximately $700 million in unsuitable expenditure. An investigation section of the 363 claims was made to establish whether the Medicare service provider that regularly verifies such claims had found any of the unsuitable expenditures. These costs include not only falsified claims, but also those without adequate documents and those for goods considered not medically essential. The new review found 20 payment mistakes that the service
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Unformatted text preview: provider recognized and 73 that it had not. These review inconsistencies to the service provider’s reliance on clinical presumption rather than additional medical records accessible from healthcare givers, the CMS's conflicting policies concerning proof-of-delivery documents, doctors not having the knowledge of document necessities and the CMS's be shortage of methods for acquiring knowledge on high risk durable medical equipment items from beneficiaries (The Washington post, 2008). The Washington Post. (2008). Health: Report Faults Medicare Audits. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2008/08/25/AR2008082502157.html Discussion Question Do you think Medicare’s auditors should check a range of records? Should Medicare contact patients to make sure that medical the equipment is in fact what is showing on the documents that are charged to Medicare?...
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HCR 230 Week 6 DQ 2 - provider recognized and 73 that it...

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