Medicare Dialysis Services Provider Compliance Review: Bio-Medical Applications of Arecibo, Inc.

Submitting OIG:

Department of Health & Human Services OIG

Report Description:

Medicare Part B covers dialysis services for beneficiaries with end-stage renal disease (ESRD). Prior OIG reviews identified inappropriate Medicare payments made for ESRD (dialysis) services that were medically unnecessary, not properly ordered, undocumented, or did not comply with Medicare consolidated billing requirements.

Date Issued:

Wednesday, March 25, 2020

Agency Reviewed / Investigated:

Department of Health & Human Services

Submitting OIG-Specific Report Number:

A-02-17-01016

Component, if applicable:

Centers for Medicare & Medicaid Services

External entity, if applicable:

Bio-Medical Applications of Arecibo, Inc.

Location(s):

United States

Type of Report:

Audit

Questioned Costs:

$96,185

Funds for Better Use:

Number of Recommendations:

View Document:

Attachment	Size
21701016.pdf	5.78 MB

Additional Details Link:

https://oig.hhs.gov/oas/reports/region2/21701016.asp

Recommendation Number	Recommendation Status	Significant Recommendation
268429	Open	No
We recommend that BMA refund to the Federal Government the portion of the estimated $96,185 in improper payments for claims incorrectly billed to the Medicare program that are within the reopening period
268430	Open	No
We recommend that BMA for the remaining portion of the estimated $96,185 in improper payments for claims that are outside of the Medicare reopening period, exercise reasonable diligence to identify any additional similar improper payments in accordance with the 60-day rule, and identify any returned overpayments as having been made in accordance with this recommendation
268431	Open	No
We recommend that BMA exercise reasonable diligence to identify and return any additional similar overpayments outside of our audit period, in accordance with the 60-day rule, and identify any returned overpayments as having been made in accordance with this recommendation

Recommendation Number

Recommendation Status

Significant Recommendation

Additional Details

268429

Open

We recommend that BMA refund to the Federal Government the portion of the estimated $96,185 in improper payments for claims incorrectly billed to the Medicare program that are within the reopening period

268430

Open

We recommend that BMA for the remaining portion of the estimated $96,185 in improper payments for claims that are outside of the Medicare reopening period, exercise reasonable diligence to identify any additional similar improper payments in accordance with the 60-day rule, and identify any returned overpayments as having been made in accordance with this recommendation

268431

Open