Are Miami Nursing Homes Overbilling Medicare? By Tod Aronovitz | 11/15/12 | 0 Comment

Inappropriate Medicare payments billed by skilled nursing facilities (“SNF”) across the U.S. resulted in $1.5 billion in overbilling during 2009, according to a new study released by the Office of Inspector General of the U.S. Department of Health and Human Services (“HHS”).

Titled, “Inappropriate Payments to Skilled Nursing Facilities Cost Medicare More than a Billion Dollars in 2009,” the report reinforces long-standing concerns about Medicare billing fraud. The submission of “inaccurate, medically unnecessary, and fraudulent claims” by nursing homes and other facilities are of particular concern.

Skilled nursing facilities provide nursing care, rehabilitation services (including physical therapy, speech therapy, or occupational therapy), and other treatments to qualifying Medicare beneficiaries. Medicare paid $32.2 billion for SNF services in fiscal year 2012.

HHS conducted a random medical record review of SNF claims submitted to Medicare in 2009 as part of the study, and found that 25% of all claims contained errors.

Miami is well known for Medicare fraud. According to a recent Miami Herald article, “The Miami area, where schemes involving home care, mental health and physical therapy fraud have flourished for years, has stood out as the nation’s epicenter of Medicare corruption.”

A Hollywood, Florida psychiatric hospital was the focus of an alleged Medicare fraud ring just last month, when federal agents from the HHS, FBI, and other agencies charged 30 South Florida healthcare professionals with Medicare fraud.

How to Report Miami Medicare Fraud

Healthcare or medical billing employees who have inside knowledge of questionable Medicare billing practices can file a confidential legal claim under the False Claims Act. By acting as a “whistleblower” in what is known as a “qui tam” lawsuit, a private party may collect between 10 to 30 percent of the amount recovered, depending on how the case is prosecuted.

ARONOVITZ LAW: Miami Whistleblower / Qui Tam Law Firm

The Miami law firm of ARONOVITZ LAW routinely works with Miami whistleblowers to document Medicare fraud and other forms of fraud against the government. Click on the link to read more about our Miami Whistleblower / Qui Tam law firm services.

Contact Miami whistleblower attorney Tod Aronovitz for a confidential discussion of your potential Miami Medicare fraud case.