◆ HealthOne Critical Care Transport Service Inc., doing business as MedicOne Medical Response of Marion, Illinois, has agreed to pay $302,124 to settle allegations it improperly billed Medicare for scheduled, non-emergency ambulance transportation, the U.S. Attorney’s Office for the Southern District of Illinois said Nov. 23.[1] “The government alleges MedicOne’s former location in Mount Vernon, Illinois, routinely billed Medicare for non-emergency ambulance transports to regularly scheduled dialysis treatments when the services did not meet Medicare requirements. MedicOne typically picked up patients at their residences or nursing homes and transported the patients to and from dialysis treatment three times per week, sometimes for years,” the U.S. attorney’s office said. Many of MedicOne’s non-emergency ambulance trips allegedly weren’t covered by Medicare because they weren’t medically necessary, particularly when patients safely took other forms of transportation, including personal vehicles, medical transport cars, and wheelchair vans, to medical appointments and social outings.
◆ In a new report, the HHS Office of Inspector General (OIG) said Medicare overpaid almost $5 million for co-surgery services from 2017 through 2019, an extrapolated amount.[2] OIG audited a stratified random sample of 100 services and concluded that 69 didn’t comply with federal requirements, including 46 that were billed without the co-surgery modifier and 14 without an assistant-at-surgery modifier—both incorrectly—and six that were inaccurately billed as duplicate services. The errors caused overpayments of $31,545.
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