It has come to our attention that the HHS Office of the Inspector General has initiated an investigation into the appropriateness of Medicare claims submitted for diagnostic sleep testing services provided by at least one Independent Diagnostic Testing Facility (IDTF). This is potentially a very serious matter given the government’s sanctioning authority that includes levying civil monetary penalties of $10,000 for every inappropriate claim plus three times the value of each of these claims. If it is determined that the individuals responsible for the operation of the IDTF knew that submitted claims were inappropriate, criminal penalties of up to five years in prison also may be imposed.
To repeat, this is a very serious matter.
Operators of IDTFs conducting sleep diagnostic services are urged to participate in a free webinar that the American Academy of Sleep Medicine will conduct on March 27. This webinar will provide information on the government’s fraud and abuse enforcement authority and the performance standards that an IDTF must maintain, including standards relating to equipment and personnel. For example, if an IDTF purchases new or replacement testing equipment, the facility must catalog the equipment and inform the applicable Medicare contractor of the equipment change within 90 days. Another standard that will be discussed relates to the requirement for non-physician personnel performing tests to be state licensed or certified, or otherwise credentialed by an appropriate national credentialing body in the absence of state licensure/certification.
Bruce Blehart, JD, Senior Health Policy Analyst, will lead the Independent Diagnostic Testing Facilities: Fraud and Abuse webinar.
Registration for the webinar is limited and will close at 12:00 p.m. CDT on Tuesday, March 24.
If you are unable to participate on the live webinar Friday, an archive of the presentation will be made available for purchase through the AASM online store. A single copy of the CD ROM is $150.00 for members and $225.00 for non-members. Orders can be placed online starting Friday.
The American Academy of Sleep Medicine will not offer CME for this specific webinar.