Legal Question in Health Care Law in California

Random Medicare audits

I recently received a random audit notice from Medicare, randomly selecting 28 cases of my 5000 files and they all involve something called chelation therapy, only. That was my only 28 cases in my finals as that was done by another physician. There is no way mathematically that this can be a random audit. The only way they could have selected those cases has to be through the codes and that is not random. What is your opinion of this ''random'' audit?


Asked on 9/22/08, 7:51 pm

1 Answer from Attorneys
Michael Stone Law Offices of Michael B. Stone Toll Free 1-855-USE-MIKE

Re: Random Medicare audits

While some proponents of alternative medicine disagree, "chelation therapy" is, in the opinion of the National Institutes of Health and the Federal Trade Commission, a scientifically unproven practice that is deprecated by mainstream medicine and that is described by some critics as "quackery."

If Medicare was charged for "chelation therapy," then the provider could be accused of Medicare fraud, a federal crime, or Medicare could demand that the provider reimburse it for the amount charged.

While you might strongly believe in the effectiveness of "chelation therapy" -- I have no dog -- you probably do not have the resources to fight Uncle Sam.

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Answered on 9/22/08, 8:11 pm


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