Report on Medicare Compliance 29, no. 25 (July 13, 2020)
◆ Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers for multi-dosing patients from single-use vials of ranibizumab and Eylea, the U.S. Attorney’s Office for the Middle District of Florida said June 30.[1] The practice didn’t admit liability in the settlement.
◆ CMS has tweaked its guidance on the CR modifier and DR condition code. An MLN Matters (SE20011 Revised)[2] adds information about “services provided by the hospital in the patient’s home as a provider-based outpatient department when the patient is registered as a hospital outpatient.”
◆ The HHS Office of Inspector General’s Work Plan has been updated with several items on COVID-19.[3]
◆ Charlene Frame, a Georgia woman who operated a telemedicine network through two companies, has pleaded guilty in a Medicare fraud scheme, the U.S. Attorney’s Office for the Southern District of Georgia said July 9.[4] Frame, who operated Royal Physician Network LLC and Envision It Perfect LLC, copped to conspiracy for conspiring to pay physicians and other providers for durable medical equipment (DME) orders that would be sold to DME suppliers and billed to Medicare.
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