First Coast Service Options, Inc., Paid Providers for Hyperbaric Oxygen Therapy Services That Did Not Comply With Medicare Requirements

Of the 120 sampled outpatient claims totaling $415,513, First Coast Service Options, Inc. (First Coast) made payments for hyperbaric oxygen (HBO) therapy in accordance with Medicare requirements for 5 claims. However, First Coast made payments for HBO therapy that did not comply with Medicare requirements for 110 claims (92 percent), resulting in overpayments for HBO therapy totaling $351,970. We did not review the remaining five claims because one was canceled and the Recovery Audit Contractor indicated that the other four were under review by another entity.