Submitting OIG:
Report Description:
From January 1, 2015, through March 31, 2017 (audit period), Pacific Medical, Inc., which is located in Tracy, California, did not always comply with Medicare requirements when billing for selected orthotic braces (i.e., back, knee, and ankle-foot braces). For 89 of the 100 sampled claims, Pacific Medical complied with the requirements. However, for the remaining 11 claims, it did not comply with the requirements. Specifically, Pacific Medical billed for orthotic braces that were not medically necessary for nine claims and could not provide medical records for two claims.
Date Issued:
Monday, December 31, 2018
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-09-17-03027
External entity, if applicable:
Pacific Medical, Inc.
Location(s):
United States
Type of Report:
Audit
Questioned Costs:
$247,493
Funds for Better Use:
$0
Number of Recommendations:
3
View Document:
Attachment | Size |
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91703027.pdf | 813.5 KB |
Additional Details Link: