Navigation Links
NICB Report On Durable Medical Equipment Fraud
Date:1/30/2013

In addition to meeting the above criteria, a licensed physician must prescribe the DME and prepare a Certificate of Medical Necessity (CMN), also referred to as a Letter of Medical Necessity. The type of medical personnel allowed to order DME will vary from state to state.  In some instances, physician assistants, nurse practitioners, and clinical nurse specialists may order DME.

In the 2011 report on National Health Expenditures (NHE), DME spending for 2010 comprised of $37.7 billion or 1.5 percent of total health expenditures (CMS, Office of the Actuary, National Health Statistics Group, 2011).  In the 2011-2021 NHE Projections, DME is projected to increase consistently at an average rate of 6 percent.  If these projections prove accurate, spending for DME could exceed $50 billion by the end of 2015 (CMS, 2011).  For both public and private health care programs, the FBI in 2011 estimated fraudulent billing to be between 3 percent and 10 percent of total health care expenditures.  If those percentages are applied to DME spending, estimates of the cost of DME fraud could fall between $1.5 billion and $5 billion in a single year.

The consistent growth of the DME industry, combined with a general lack of required credentials or training in order to distribute DME, provides ample opportunity for unscrupulous individuals and entities intent on defrauding the insurance industry.

Although DME fraud is but a small part of the overall medical fraud perpetrated against insurers and the government, it is most insidious, as evidenced by the conviction noted previously when patients who have been properly prescribed for DME never receive it. Somewhere in the DME processing chain between doctor and patient, the device never gets delivered.  Whether it's diverted to others, lost in bureaucracy or simply pilfered to be sold on the black market, it is an expensive loss to patients, insurers and the government—a loss that all
'/>"/>

SOURCE National Insurance Crime Bureau
Copyright©2012 PR Newswire.
All rights reserved

Page: 1 2 3 4

Related medicine technology :

1. Haemonetics Reports 3rd Quarter Fiscal 2013 Revenue Up 29% and $0.50 Adjusted EPS; Year-To-Date Organic Revenue Up 3%; Reaffirms Fiscal 2013 Adjusted EPS Guidance of $1.65-$1.70
2. PAREXEL International Reports Second Quarter Fiscal Year 2013 Results
3. Lilly Reports Fourth-Quarter and Full-Year 2012 Results, Revises 2013 EPS Guidance
4. Danaher Reports Record Fourth Quarter 2012 Results
5. Regeneron to Report Fourth Quarter and Full Year 2012 Financial and Operating Results and Host Conference Call and Webcast on February 14, 2013
6. New Report: Drugstore Networks Could Save Employers, Medicare, and Medicaid $115 Billion
7. Free Research Report on Delta Air Lines, Inc., Johnson & Johnson, Barrick Gold Corp., Exelon Corp. and Cirrus Logic, Inc.
8. Free Research Report on Ford Motor Co., Pfizer, Inc., Barclays Bank PLC, General Electric Co. and PowerShares QQQ Trust
9. Encision Reports 10% Product Revenue Increase in Third Quarter of Fiscal Year 2013 Results
10. Education and Collaboration Key to Continued Progress in Fighting Rogue Online Prescription Drug Sellers, Reports NABP
11. Uroplasty Reports Fiscal Third Quarter 2013 Financial Results
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/6/2015)... Mass., May 6, 2015 NxStage Medical, Inc. (Nasdaq: ... products, today reported first quarter financial results that exceed ... Revenue for the first quarter of 2015 increased ... $72.2 million for the first quarter of 2014. The ... $77.5 million to $78.5 million.  The increase was driven ...
(Date:5/6/2015)... 2015  Galmed Pharmaceuticals Ltd. (Nasdaq: GLMD ) ... and commercialization of a once-daily, oral therapy for the ... that it will host a conference call and webcast ... the period ended March 31, 2015 and to provide ... clinical program for aramchol. Conference Call ...
(Date:5/6/2015)... 6, 2015   Sigma-Aldrich Corporation (NASDAQ: SIAL ... today announced a $50,000 product donation to the ... replicate key findings from recent high-impact papers in the ... between the online research marketplace Science Exchange , ... the open-access journal eLife. The goal of ...
Breaking Medicine Technology:NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 2NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 3NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 4NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 5NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 6NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 7NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 8NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 9NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 10NxStage Reports First Quarter 2015 Financial Results And Exceeds Guidance 11Galmed Pharmaceuticals First Quarter 2015 Conference Call and Webcast Scheduled for Wednesday, May 13, 2015 2Galmed Pharmaceuticals First Quarter 2015 Conference Call and Webcast Scheduled for Wednesday, May 13, 2015 3Sigma-Aldrich Donates $50K in Products to the Reproducibility Project to Foster Replicable Research and Accelerate Scientific Discoveries in Cancer Biology 2Sigma-Aldrich Donates $50K in Products to the Reproducibility Project to Foster Replicable Research and Accelerate Scientific Discoveries in Cancer Biology 3
... the American,Society of Hematology (ASH) and the American ... joint guideline on the use of,erythropoiesis-stimulating agents (ESAs), ... to produce more red blood cells, to treat,chemotherapy-related ... to inform clinicians with the most,up-to-date evidence from ...
... and efficacy of TAXUS drug- ... stent compared to bare-metal stent, NATICK, Mass., and WASHINGTON, ... announced five-year and final,follow- up data from its TAXUS IV ... -- in patients who received a TAXUS(R),Express(TM) Paclitaxel-Eluting Coronary Stent ...
Cached Medicine Technology:ASCO and ASH Release Updated Guideline on the Use of Chemotherapy-Related Anemia Treatments in Cancer Patients 2ASCO and ASH Release Updated Guideline on the Use of Chemotherapy-Related Anemia Treatments in Cancer Patients 3Positive Five-Year Safety Data for TAXUS(R) Stent Reported in Boston Scientific Trial 2Positive Five-Year Safety Data for TAXUS(R) Stent Reported in Boston Scientific Trial 3Positive Five-Year Safety Data for TAXUS(R) Stent Reported in Boston Scientific Trial 4
(Date:5/6/2015)... Anitha Nallari, MD has joined Shakir ... in Columbus, OH. Dr. Nallari will see patients with ... breast cancer, lung cancer, GI and gallbladder cancer, head and ... hematology. , Dr. Anitha Nallari is Board Certified ... Board of Internal Medicine. She completed her medical education in ...
(Date:5/6/2015)... Anitoa Systems, (“Anitoa”), a Palo Alto startup ... China, has successfully demonstrated a handheld real time quantitative-polymerase-chain-reaction ... Anitoa’s handheld qPCR is shown to be capable of ... hepatitis B, C, and E. Coli. This qPCR system ... and over 9 orders of magnitude dynamic range. ...
(Date:5/6/2015)... The 2015 STEMtech conference exhibition hall ... booth selection . Don’t miss this opportunity to ... and university decision-makers from around the country. , This ... the Arizona Grand in Phoenix. This beautiful all-suite hotel ... doorstep of the South Mountain Preserve. The Phoenix area ...
(Date:5/6/2015)... Los Angeles, California (PRWEB) May 06, 2015 ... has secured its first round of VC funding and ... , The enterprise class embeddable software enables applications ... transform data as it moves between systems and locations. ... the HyperTransfer technology moves files at line speed, independent ...
(Date:5/6/2015)... New york, NY (PRWEB) May 06, 2015 ... on strategy, design, creative and technology, announced today that ... an expert advisor by Shocase, a marketing professional network ... the marketing sector. , Widely regarded as a specialist ... of the most high-profile branding programs over the last ...
Breaking Medicine News(10 mins):Health News:New Oncologist to Join Hematology Oncology Consultants, Inc. 2Health News:New Oncologist to Join Hematology Oncology Consultants, Inc. 3Health News:Anitoa Systems Demonstrates Compact qPCR using Ultra Low-Light CMOS Bio-Optical Sensor 2Health News:Anitoa Systems Demonstrates Compact qPCR using Ultra Low-Light CMOS Bio-Optical Sensor 3Health News:STEMtech Conference Exhibitors Gain Access to Community College and University Representatives From Across the U.S. 2Health News:TransferSoft Launches Industry’s Most Comprehensive Data Movement Technology Suite to Optimize Disaster Recovery, Big Data, and Cloud Applications 2Health News:TransferSoft Launches Industry’s Most Comprehensive Data Movement Technology Suite to Optimize Disaster Recovery, Big Data, and Cloud Applications 3Health News:TransferSoft Launches Industry’s Most Comprehensive Data Movement Technology Suite to Optimize Disaster Recovery, Big Data, and Cloud Applications 4Health News:Shocase Selects MBLM’s Claude Salzberger as Company Advisor 2
... survival of cells that are exposed to stress. Researchers at ... operation some time ago but now Hsp90 has surprised ... results are published in the current online issue of the ... cancer medication. Proteins are the motors of the cell: ...
... Playing "media detective" allows children to understand the intentions of ... resist messages that encourage alcohol or tobacco use. ... shows that teaching children as early as third grade to ... use. The study, based on the research of Erica Weintraub ...
... Steven Reinberg HealthDay Reporter , MONDAY, Aug. 23 ... potentially tainted by salmonella, the head of the U.S. Food ... additional sort of sub-recalls over the next couple of days, ... distribution of these eggs that are contaminated," agency director Margaret ...
... at math in school, so that,s what she pursued as a ... Houston, Texas, and met some cardiologists at a party, she started ... them. "I realized we could provide them with a fluid ... about, for example, which stent grafts they use in their procedures," ...
... flooding of New Orleans caused the evacuation of 1.5 ... remained displaced, many residing in highly transitional shelters, including ... mark, substantial consequences from this prolonged displacement have resulted ... the region, according to a new study by the ...
... Although the medical community has already accepted that colorectal ... researchers have found that computed tomography colonography (CTC or ... the yield of identifying significant early extracolonic (outside the ... study in the September issue of the American Journal ...
Cached Medicine News:Health News:Munich researchers demonstrate rocking movement in the anti-stress protein Hsp90 2Health News:'Media detective' tool empowers children to skirt alcohol and tobacco marketing messages 2Health News:FDA Chief Says More Egg Recalls Possible 2Health News:FDA Chief Says More Egg Recalls Possible 3Health News:FDA Chief Says More Egg Recalls Possible 4Health News:Math from the heart: Simulating stent design and coating 2Health News:Math from the heart: Simulating stent design and coating 3Health News:'Legacy of Katrina' report details impact of stalled recovery on mental health status of children 2Health News:'Legacy of Katrina' report details impact of stalled recovery on mental health status of children 3Health News:'Legacy of Katrina' report details impact of stalled recovery on mental health status of children 4
... The Uniflex Humeral Nail System has been ... in which noninvasive treatments have historically failed ... a unique blend of strength and flexibility. ... strength of titanium alloy is twice that ...
... Building on a strong heritage, the ... a new standard in ophthalmic ultrasound instrumentation. ... options, OcuScan RxP makes it simple to ... reproducible. Designed to enhance patient care by ...
... The AIM Titanium Tibial ... address the mechanical failures of ... indications for tibial interlocking nails. ... full range of diameters and ...
Arthroscopic instrument system for instability and SLAP fixation....
Medicine Products: