OIG Spots $20 Million in Questionable Portable X-Ray Billing

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The Office of Inspector General for the Department of Health and Human Services identified questionable billing practices by 20 portable x-ray suppliers totally nearly $20 million, according to a recent report.

Medicare paid roughly $225 million in 2009 to portable x-ray suppliers that deliver in-home services using mobile diagnostic equipment. During an audit, investigators spotted roughly $12.8 million in questionable billing patterns for return trips to nursing facilities on a single day as well as $6.6 million in Medicare services ordered by non-physicians, which are not covered.

The OIG report makes clear that some of the $12.8 million could be legitimate, which must be determined through further investigation.

Medicare pays portable x-ray suppliers for transportation, setting up the equipment, administering the test and interpreting the results. However, 80 percent of what Medicare paid suppliers in 2009 amounted to transportation and setting up the equipment. The audit found that suppliers were likely billing for return trips when they may have been servicing more than one patient during the same visit, in which case the supplier should only be reimbursed once for the transportation component.

The OIG recommends the Centers for Medicare and Medicaid Services collect the $6.6 million ordered by non-physicians, establish procedures to ensure that it pays for portable x-ray services that are only ordered by a physician and that it periodically identify those suppliers that merit greater scrutiny.

For the full report click here.