Friday, May 2, 2014

Health Care Attorney Tracy Green Quoted in USA Today Article On Chiropractors Being One Largest Medicare Billers. Article Is Result of CMS Releases for First Time Data On Medicare Payments For 2012 By Provider.

Ever since Medicare decided last month to release its 2012 data showing all the payors (physicians and other suppliers), journalists have been reviewing the data and trying to determine how certain providers are getting paid such large amounts. The CMS website has all the data in an Excel spreadsheet that can be downloaded and each physician and supplier can be searched. It's actually an incredible disclosure of private information in that physicians' and suppliers' addresses are there as well as their collections.

I must admit that I searched for my own clients to let them know what the data revealed and gave my clients a heads' up that they may get calls from reporters (which happened in a couple of cases). But providers should review this data so they know what is there. Technically, this is private information but be aware that your patients, employees, friends, ex-spouses, et al., can review this to see your gross collections (of course it does not address

For many of the physicians and suppliers, the numbers are misleading since the billing may reflect an entire group that is being billed under the name of one owner. For others it may be an accurate reflection. However, this is the first time the collections have ever been revealed. The New York Times has posted a link that allows one to search by provider name.

One of the questions that arose is how are chiropractors such a large Medicare group and why are their billings so high? USA Today looked at chiropractors and in the article entitled "Some Chiropractors Making Big Medicare Paid Adjustments," I was quoted on why chiropractors are being looked at in particular. This reporter's editor was particularly interested in chiropractors.

My quote was:

"Los Angeles health care lawyer Tracy Green has represented many chiropractors and says the specialty has "a fair amount of regulatory problems and fraud." Part of the problem is that "they are the ones doing the care" frequently in auto insurance fraud cases and some run pain management clinics, a field that's closely watched given all the pain medication abuse and fraud."

Although it doesn't reflect fully my comments, it is important for providers to see where they are in this list and how they rank compared to similar providers since it will be used as a source of audits and scrutiny. There is no question that physical therapy and chiropractor providers will be at risk for more audits since the charting requirements are incredibly strict and CMS often challenges on medical necessity.

Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law
Los Angeles, California 90017
Phone: 213-233-2260


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