The Office of Inspector General conducted unannounced visits to 132 independent diagnostic testing facilities in the Los Angeles area, finding 46 of them to be noncompliant with selected Medicare standards, according to an OIG report.
Of those that were noncompliant, 24 were not at the locations on file with CMS and 22 were not open during business hours. Of those 46 IDTFs, 25 had submitted claims representing services performed on the same dates that officials visited their locations.
The OIG has made three recommendations following the IDTF audit in Los Angeles:
Unannounced site checks to IDTFs should be conducted periodically. The OIG said CMS should focus these visits on high-risk areas or base them on fraud risk assessments.
Impose a moratorium on new IDTF enrollments in the Los Angeles area. This would prevent new IDTF enrollments in the Medicare program while CMS develops more safeguards for IDTFs in the area.
Take appropriate action against noncompliant IDTFs marked in the report. The OIG suggested CMS investigate the 46 IDTFs found to be noncompliant and revoke billing privileges if warranted.
Related Articles on Medicare Fraud:
GAO: CMS Needs to Clarify Goals, Improve Data Used to Measure Medicare Integrity Program
CMS Administrator: Technology Necessary in Fight Against Medicare Fraud
GAO: Medicare Represents Roughly 38% of Federal Government Improper Payments
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