MARIN COUNTY: Paramedics Probed in Medicare Billing Dispute
Several of Marin County's paramedic agencies may have violated Medicare billing and collection rules, according to a recent Marin County civil grand jury report, the Marin Independent Journal reports. In the report, the panel cited five agencies for improper emergency transport billing practices. The agencies were charged with routinely waiving Medicare copayments and deductibles, billing Medicare but not other payers for transport and overbilling Medicare. The violations could render taxpayers liable for substantial fines. While the report conceded that Medicare regulations are "complex and easily violated," it maintains that the agencies must do more to "prevent violations that might have been committed as a matter of policy." Some top county officials disputed the jury's findings. San Raphael Fire Chief Robert Marcucci blasted the report, calling it "fallacious." He said, "What it says about the billing practices in San Rafael is totally false ... the grand jury has done a great disservice to the city and its residents and paramedics." Although HCFA spokesperson Craig Polaski declined to comment on the report, he referred to an Inspector General's bulletin that states that waiving Medicare copayments may violate a federal "anti-kickback" statute. Hal Hassin, chair of the HHS subcommittee that initiated the investigation, added that federal regulators have cracked down on health providers nationwide for similar violations, issuing fines of up to $2,000 for each Medicare infraction. The report calls for the county's Emergency Medical Services Agency to be given the authority to approve the billing and collection practices of the county's paramedic agencies (Ashley, 6/18).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.