Tuesday, June 30, 2009

FL - Miami Dade County Medicare Fraudsters Named

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Eight Miami-Dade County (Florida) residents have been indicted in connection with an alleged $22 million Medicare fraud scheme operated out of Miami businesses purporting to specialize in home health care services reports this Medical News Today article, Eight Miami-Area Residents Charged In $22 Million Medicare Fraud Scheme Involving Home Health Care Agencies.

There's no hiding now, as this article calls out the names of folks indicted. Furthermore:

"Health care fraud schemes in South Florida range from simple billing schemes and fly-by-night durable medical equipment providers, to more sophisticated frauds, including infusion fraud, fraud on the Medicare Advantage Program, and now fraud in the delivery of home health services," said Acting U.S. Attorney Jeffrey H. Sloman. "Today's coordinated criminal and civil action delivers an effective one-two punch to health care fraudsters: they were not only caught and criminally charged, but they are also being stripped of their illegal proceeds."
Related Posts:
Florida Cracks Down On Miami DME Fraud

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Tuesday, June 23, 2009

Florida Cracks Down On Miami DME Fraud

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The Miami Herald reports, Florida probes Miami-area medical-equipment kickbacks - Medicaid investigators are targeting fraud in Miami-Dade County, zeroing in on questionable billing for medical equipment. They report investigations of providers suspected of bilking the state healthcare program for low-income people by billing for oxygen concentrators that are not medically needed. Investigators also visited more than 120 Medicaid patients, some of whom may have received kickbacks from medical equipment suppliers for ordering their products.

Of note, investigators indicate that unnecessary billing for oxygen concentrators has been a particular problem over the past five years. According to Holly Benson, secretary for the Florida Agency for Health Care Administration, said fraudulent billing for oxygen concentrators is the latest scam ailing Medicaid, which spent $90 million on medical equipment in fiscal 2007-08. About 25 percent of that spending, funded by state and federal taxes, was in Miami-Dade.

In summary, it's especially important to have things in order if you're near Miami and billing for oxygen concentrators.

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Tuesday, June 16, 2009

Pharmacy Designated Representative Training Requirements

If you're new to the pharmacy world of the Designated Representative, maybe this quick introduction will help. I'm going to explain, using the California (CA) State Board of Pharmacy as the example.

According to the CA Designated Representative application form:
A designated representative is an individual who performs clerical, inventory control, housekeeping, delivery, maintenance, or similar functions related to the distribution or dispensing of dangerous drugs or dangerous devices. To work as a designated representative, you must possess and keep a current certificate as a designated representative.
There are quite a number of requirements that have to be met in order to qualify, including the following training requirements listed on the application form:
Complete a training program that, at a minimum, addresses each of the following subjects:
(A) Knowledge and understanding of California and federal law relating to the distribution of dangerous drugs and dangerous devices.
(B) Knowledge and understanding of California and federal law relating to the distribution of controlled substances.
(C) Knowledge and understanding of quality control systems.
(D) Knowledge and understanding of the United States Pharmacopoeia standards relating to the safe storage and handling of drugs.
(E) Knowledge and understanding of prescription terminology, abbreviations, dosages and format.

The trick then becomes finding a way to fulfill the training program requirement. I've posted links to training and certification service providers below.

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CA HMDR Exemptee online internet-based training certification by SkillsPlus Intl Inc.
The Exemptee Institute

NEW! CA Designated Representative-3PL online training certification by SkillsPlus Intl Inc.- We'll send you the 3PL training affidavit upon successful course completion.
CA Designated Representative online web-based training certification by SkillsPlus Intl Inc. - Available around-the-clock 24 x 7
FL Certified Designated Representative (CDR) online exam prep course - Lots of practice exams - Practice makes perfect!
The Designated Representative Institute

The Designated Rep and Exemptee Professionals Blog
SkillsPlus Intl Info Blog

Thursday, June 11, 2009

CA Man Sentenced For Prescription Drug Diversion

Uh-0h. Don't get caught like this. Read this Department of Justice (DOJ) news release to see what I mean, California Man Sentenced For Prescription Drug Diversion.

According to the release, the Californian man was "was sentenced to 52 months of incarceration to be followed by three years of supervised release for illegally distributing large quantities of Serostim, an HIV drug, which were illegally purchased from illegitimate sources and then illegally sold to wholesale distributors in various parts of the country, using falsified paperwork."

Here's what this means to you, "The Prescription Drug Marketing Act (“PDMA”) requires wholesale distributors of prescription drugs to be licensed by the states in which they operate. Pursuant to the PDMA, the FDA enacted minimum state guidelines for state licensing of wholesale distributors of prescription drugs. The PDMA generally requires wholesale distributors of prescription drugs to provide to the recipient of the drugs a statement indicating each prior sale of the drug including the names of all parties to the transactions. This statement is generally referred to as the “Drug Pedigree.” The minimum state guidelines and the drug pedigree requirement are designed to eliminate potential risks to the public health by protecting the integrity of the drug distribution system."

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Tuesday, June 9, 2009

New Organization Announced - Committee to Save Independent HME Suppliers

This PR Newswire release announces the formation of a new organization, New Organization Formed To Save Independent Medical Equipment Suppliers.

You might be interested in this new organization, Committee to Save Independent HME Suppliers, LLC (CSI: HME), because this non-profit business league was created to respond to the growing threat that recent policy changes pose to the future of independent medical suppliers and the patients they serve.

In reading the press release, I learned that small home medical equipment suppliers account for 85% of suppliers in the Medicare Program.

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Saturday, June 6, 2009

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From SkillsPlus International Inc.