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Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-02-17-01016
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.

Report Type
Audit
Location

PR
United States

Number of Recommendations
6
Questioned Costs
$96,185
Funds for Better Use
$0
Additional Details
https://oig.hhs.gov/oas/reports/region2/21701016.asp
External Entity
Bio-Medical Applications of Arecibo, Inc.

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
268431 No $0 $0

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

268429 No $96,185 $0

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 No $0 $0

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

Department of Health & Human Services OIG

United States