HHS OIG Analysis Part 2 of 2 – Read Part One of the Analysis October 1, 2015 Yesterday, the American Ambulance Association summarized a report from the Department of Health and Human Services Office of the Inspector General (OIG) on certain questionable billing practices by ambulance suppliers. In this report, the OIG indicated that 1 in 5 ambulance providers had engaged in one or more of the following “questionable billing” practices”: Billing for a transport without a Medicare service being provided at either the origin Billing for excessive mileage for urban transports Billing for a high number of transports per beneficiary Billing using compromised beneficiary ID numbers Billing for an inappropriate or unlikely transport level Billing for a beneficiary that is being shared among multiple ambulance suppliers Billing for transports to/from a partial hospitalization program In this member advisory, I want to devote additional attention to the questionable billing practice the OIG referred to as “inappropriate or unlikely transport levels”. The OIG identified 268 out of the 15,614 ambulance suppliers reviewed (2%) that had questionable billing based on the percentage of claims submitted with inappropriate or unlikely combinations of transport levels and destinations.  The OIG summarized its findings as follows:…

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