Waste Fraud And Abuse in the Medicare Program Joint Hearing Before the Subco

Cover Waste Fraud And Abuse in the Medicare Program Joint Hearing Before the Subco
Waste Fraud And Abuse in the Medicare Program Joint Hearing Before the Subco
United States Congress House Committee On Comme
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I would like to make two points. Number one, the nursing home administrator does not see the bills. Number two, the doctor doesn't see the bills. That is a big part of the problem is they don't see the bills, and that is why there isn't a recognition that that kind of money is being sent.
Mr. Stearns. Is that true, Mr. Seide, that they have no idea? The long-term provider has no idea that the patient is billing at a rate of $85, 000 a year for bandages?
Mr. Seide. The facility does get the EOMB
...s, the end of month billing statement from the carrier. I don't know what section it goes to, but the facility does get that EOMB. I don't know who it is dis- persed to and who sees it. I don't know that, but the carrier does nave to submit the EOMB at the end of the month for the services provided.
Mr. Stearns. From what you know, Mr. Seide, the administrator has to have some knowledge that they are spending $85, 000 a year for bandages, wouldn't you suspect?
Mr. Seide. Don't forget this kit, one of the reasons I picked it is because everything is individually wrapped.


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