OIG Releases Report on Excessive Medicare Billing

Why do nursing homes commit so much abuse? A lot of it can rest on the shoulders of profit. Medicare treatment provides a large cash cow to nursing homes. Used judiciously, it can help people who couldn’t afford medical care to get it. But some companies send fraudulent bills or perform unnecessary services on patients just so they can get a payment.

The Office of Inspector General has been looking into Medicare billing and has released a disturbing report. They have found that while the age and health condition of most nursing home residents has stayed the same there has been an increase in more intensive physical and occupational therapy treatments. $1.1 billion was spent on these services through Medicare in 2013.

Part of the problem is Medicare’s payout system. The CMS believes that it is paying too much for certain skilled-nursing activities. They hope to control spending by racheting down the amount they pay out over time. They also found that many nursing homes are billing the exact number of minutes so they can qualify for a higher-level payout category.

Excessive therapy can actually cause long-term damage depending on the ailment and the treatment. It can also cost you and your loved one extra out of pocket expenses. If you believe your loved one is receiving unnecessary treatment, contact Schenk Smith Trial Attorneys. We can advise you on whether you may have a malpractice case on your hands.