A recent article at Bloomberg reads in part: " How does an emergency medical technician support Medicare fraud claims against an ambulance company without access to billing records and other claim specifics? “Let me show you!” wrote one federal judge in Pennsylvania." Full article here
Kevin Fairlie Contributes Article to Fall 2017 EMS Connection Publication Detailing Increased DOJ Oversight of Emergency Based Services
Historically, when it came to EMS services, most of the scrutiny from the Department of Justice (DOJ) and the Centers for Medicare and Medicaid Services (CMS) was focused on non-emergency basic life support transports. 2017 has seen a significant shift from this previous trend. Read the full article in the Fall 2017 issue of EMS Connection.
Kevin Fairlie Invited Speaker at the Missouri Ambulance Association’s Annual Board Member and Management Training conference on June 14th, 2017
Kevin will lead three one hour sessions covering timely employment law issues including the proper handling of internal investigations, social media in the EMS workplace and changing drug laws. Joining Kevin in these sessions will be attorney J.P. Hasman. J.P. is a shareholder in the St. Louis office of Ogletree, Deakins where he counsels and defends employers regarding all aspects of the employment relationship. More information on the sessions is below.
Proper Handling of Internal Investigations
Social Media in the EMS Workplace – Risks and How to Avoid Them
Changing Drug Laws and the Impact on Employment Drug Testing and Enforcement
Kevin Fairlie authors article in Spring EMS Connections publication: "The EMS Compliance and Regulatory Landscape under the Trump Administration: A Look into the Future"
Mr. Fairlie is again a featured contributor to the "Legal Corner" in this month's EMS Connections magazine. You can read his thoughts on the future of regulatory oversight for EMS Agencies and find the full article at EMS Connections
Fairlie Law Managing Member, Kevin Fairlie, will be speaking again at the nation's leading conference for EMS leaders. Mr. Fairlie will be presenting at two Pinnacle Power Seminars: "What you Don't Know Can Hurt You: How to Manage Regulatory and Other Investigations" and "Bending the Curve to Achieve Financial Sustainability." You can find more information about the renowned Pinnacle EMS conference at their website here.
Missouri Medicaid Audit and Compliance (MMAC) to Conduct Onsite Audits of Missouri Ambulance Providers
On December 22, 2016, MMAC issued a Memo indicating that it will begin conducting onsite audits to determine whether information provided during provider enrollment is accurate. MMAC stated that it would conduct audits for providers it classifies as Moderate or High risk to the Missouri Medicaid program. Missouri Ambulance Providers are listed as moderate risk entities by MMAC. Therefore, Missouri Ambulance Providers should be reviewing their Medicaid enrollment and revalidation information and take steps to ensure that information provided to MMAC is correct.
If you have questions on this process, please contact the firm for further assistance. You may contact Kevin Fairlie directly here
Fairlie Law, LLC is proud to sponsor the 18th Annual Jack Buck Golf Classic in support of the American Parkinson's Disease Association
This is a great event in support of a wonderful cause and a wonderful organization. More information at the event website.
Expect more oversight of EMS billing through post-payment audits and increased investigations, prosecution
Founding Member, Kevin Fairlie, authors a new article at www.EMS1.com
Health care providers of all shapes and sizes have seen an increase in Medicare and Medicaid payment audits after the implementation of the Affordable Care Act and its many provisions for safeguarding Medicare and Medicaid. The Office of the Inspector General at the U.S. Department of Health and Human Services says the Centers for Medicare & Medicaid Services should increase monitoring of ambulance billing. Here is what increased monitoring will look like and how it will impact EMS agencies.
EMS agencies should expect audits to increase in frequency and complexity. A September 2015 study released by the OIG found that roughly 1 in 5 ambulance providers had questionable billing practices.
The study recommended that CMS increase its monitoring of ambulance billing. This will come in the form of billing audits in which EMS agencies will be required to justify, through appropriate documentation, that their claims are legitimate. If agencies cannot, they will face potentially large paybacks — returning Medicare and Medicaid payments. Read the full article here
The Centers for Medicare & Medicaid Services (CMS) extended the temporary moratoria on the enrollment of new Medicare Part B ground ambulance suppliers in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey. This is a 6 month extension.
CMS stated that it extended the moratoria based on a high risk of fraud, waste, or abuse in these provider and supplier types within those geographic locations.
The information was posted February 2nd in the Federal Register and can be found here.
Fairlie Law Managing Member, Kevin Fairlie, contributes article on the OIG and increased federal oversight of EMS billing - published today in Paramedic Chief at EMS1.com