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OIG Releases Critical Ambulance Report

OIG Builds a Case for More Enforcement

September 25, 2013

FROM: Page, Wolfberg & Wirth, LLC
RE: OIG Releases Critical Ambulance Report

The Department of Health and Human Services Office of Inspector General (OIG) released a crucial Report that foreshadows more fraud enforcement for the ambulance industry, especially in the BLS nonemergency sector. The Report, Utilization of Medicare Ambulance Transports, 2002-2011, takes a sharp look at the growth of Part B Medicare transports since 2002 and finds that payments for ambulance transports have grown at a faster rate than ALL Medicare Part B payments.

In the Report, the OIG points the finger squarely at BLS nonemergency transports as the primary reason why there has been what the OIG calls a "growing and disproportionate" increase in ambulance transports since 2002. The OIG found that dialysis-related BLS nonemergency transports increased 269% from 2002 to 2011. It's no secret that the OIG has long believed that billing for dialysis-related transports is highly susceptible to fraud and abuse. But this Report goes as far as to state: "Although dialysis facilities are a covered destination, transports to them do not usually meet coverage requirements under Medicare."

The announcement is also a precursor to a forthcoming report from the OIG, where it will identify ambulance suppliers that exhibited "characteristics of questionable billing" in the first half of 2012 and where those suppliers are located. You won't believe what else is in today's Report, including findings about increases in overall ambulance transports and ALS emergency utilization rates.

Click HERE to read PWW's article: "8 Big Findings From the OIG's Utilization Report" to find out what else we uncovered.

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