Federal auditing records were released Wednesday, showing Medicare records have risen more than a couple financial concerns.
The auditors found a particular discrepancy where $30 million was spent on patients that rode in an ambulance never received any medical services where they were picked up or where they were dropped off at.
They also found that urban ambulance rides consisted of an average of 10 miles being driven, however there are instances where the ambulance was paid while they drove more than 100 miles.
A pattern has been noticed, with 1 in 5 ambulance companies having discrepancies in their billings that simply are not adding up with the auditors, reported MSN.
"Medicare payments for ambulance transports have increased in recent years, and investigators have uncovered a variety of fraud schemes involving ambulance suppliers," the report said.
The audit dove deep into records, looking back an entire year through Medicare's inpatient, outpatient, nursing home, hospice, and physician claims databases, searching for more clues to where the $30 million was used. However, they are not logging cases where the patient died within a day of being transported by an ambulance. Sometimes, billers might not report the correct pickup and drop-off locations of the deceased.
Medicare has been examined closely before. In 2012, $5.8 billion was paid by outpatient care for ambulance rides. Obviously, this raised some questions, since this was double the amount paid in 2003. This was when auditors realized that Medicare paid $24 million for ambulance rides that didn't meet program requirements for payment.
As the investigation continued they found a link in four metro areas that appear to be the centralized areas for falsifying ambulance driving records. Philadelphia, Los Angeles, New York and Houston accounted for about half of the questionable rides and payments. Because of this, Medicare will not be allowing any new ambulance companies to join those particular cities.
Suggestions have been made by the general inspector to Medicare to help improve its future audits. It will require more detailed documentation and placing holds on payment claims that don't meet the basic requirements, according to CBS News.
The last addition that Medicare is going to make to ensure better audits in the future is that it is now going to require prior approval for any repeat non-emergency ambulance rides in New Jersey, Pennsylvania and South Carolina. Next year it will go even further by requiring the same from Delaware, Maryland, North Carolina, Virginia and West Virginia, plus Washington, D.C., reported by APN News My Way.
