Submitting OIG:
Report Description:
DVA Laboratory Services, Inc. (DVA), did not always comply with Medicare requirements for tests billed with an AY modifier for beneficiaries with end-stage renal disease (ESRD). Specifically, for 62 of the 100 beneficiary-days, DVA submitted separate claims using the AY modifier for tests furnished for the treatment of ESRD contrary to the consolidated billing requirement. In addition, DVA did not always comply with other Medicare requirements. These errors occurred primarily because DVA did not have adequate controls to comply with certain Medicare requirements. On the basis of our sample results, we estimated that Medicare overpaid DVA at least $989,000 for tests that were furnished for the treatment of ESRD.
Date Issued:
Friday, January 22, 2016
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-01-14-00508
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
DVA Laboratory Services, Inc.
Location(s):
FL
United StatesType of Report:
Audit
Questioned Costs:
$1,458,496
Funds for Better Use:
$0
Number of Recommendations:
6
View Document:
Attachment | Size |
---|---|
11400508.pdf | 8.06 MB |
Additional Details Link: