Submitting OIG:
Report Description:
Some chiropractic services that Etheredge billed were not allowable in accordance with Medicare requirements. Of the 100 chiropractic services in our sample, 67 were allowable in accordance with Medicare requirements. However, the remaining 33 were not allowable: 31 services were medically unnecessary and 2 were not documented. As a result, Etheredge received $1,042 in unallowable payments. On the basis of our sample results, we estimated that Etheredge received unallowable Medicare payments of at least $169,737 for 2014 and 2015. As of the publication of this report, this unallowable amount includes claims outside of the 4-year claims reopening period.
Date Issued:
Wednesday, September 19, 2018
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-04-16-07064
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
Etheredge Chiropractic
Location(s):
FL
United StatesType of Report:
Audit
Questioned Costs:
$169,737
Funds for Better Use:
$0
Number of Recommendations:
4
View Document:
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Additional Details Link: