Hello Colleagues and Guests,
Yes, we too have had this problem and Medicare has taken back several
thousand dollars for a 2009 claim. Their claim is that the patient was
incarcerated at the time services were rendered. Such is and was not the
case. Even though we presented affidavits from law enforcement
officials, CMS still denied the claim stating the Social Security
records of the individual state otherwise. How an incarcerated patient
can show up in our office without an orange or some loud colored
uniform, handcuffs and ankle chains, and an escort police officer is
beyond me. Neither was this person wearing a tracking monitor. In the
meantime, our only option is a hearing with an ALJ judge, which is
taking months and months to get to. Folks, this is just one more example
of a federal government that is totally out of control and could care
less. Until we STOP these criminal and fraudulent actions by our
government agencies, we can kiss our profession goodbye, and I will go
ahead and add, our national freedoms. How sad that a few calloused
bureaucrats can bankrupt legitimate businesses who are trying to take
care of disabled individuals in an honorable manner. From my viewpoint,
the fraud is primarily inside the DC beltway. I am beginning to think
there is more to this story than I would like to know. Eliminate the
competitive market place and all that is left is government. Of course
they will contract with someone. Why? Because they are incapable of
providing the services otherwise.
By the way, I was told a few months ago that the Canadian healthcare
system is wonderful. As such, I asked one of my friends who grew up in
Canada, but who has lived here for several years his opinion of their
system. Most all of his family still live there. He had a two word
answer for me. It sucks! Then, he went on to explain about his
relatively well-to-do farmer brother who was diagnosed with cancer. When
his brother finally arranged to bypass the system, rather than wait the
several weeks or months otherwise, he denied that care as well when he
learned that he was keeping another patient from their care. He went
elsewhere and his cancer was cured. He has since passed, but not because
of cancer. I’ve heard other sad stories about the Canadian health care
system, but this cane first hand. I have also heard that the Canadian
system is about under water. May not be true, but that’s what I’ve heard.
Wil Haines, CPO
MaxCare Bionics
Avon, IN
On 7/9/2013 4:10 PM, David Hill wrote:
> Has anyone received requests to pay back over payments due to the person
> being incarcerated. We received a letter from Medicare stating that the
> Social Security Administration records indicated the patient was in prison
> when services were rendered. The patient came into our office independently
> without any sign of being incarcerated. We have checked the criminal record
> and found there was no incarceration on the state or federal level for our
> dates of service in 2010 and 2011. We are in the region D. If you’ve had
> this problem how did you remedy it? I really don’t want to go through a
> lengthy appeals process because of incorrect information from the Social
> Security Administration. Any suggestions would be helpful thanks David Hill
> BOCO. my e-mail is [email protected]
>
> ********************
> To unsubscribe, send a message to: [email protected] with
> the words UNSUB OANDP-L in the body of the
> message.
>
> If you have a problem unsubscribing,or have other
> questions, send e-mail to the moderator
> Paul E. Prusakowski,CPO at [email protected]
>
> OANDP-L is a forum for the discussion of topics
> related to Orthotics and Prosthetics.
>
> Public commercial postings are forbidden. Responses to inquiries
> should not be sent to the entire oandp-l list. Professional credentials
> or affiliations should be used in all communications.
>
