I have read these forums for some time and am saddened that PPS has become what these forums paint. it wasnt always this way, anyways onto my point. The following is a brief description on how to actually do something.
A. if you suspect fraudulent paperwork such as CMN, RX, etc, make copies of said paperwork for your own records. gather names of patients, people involved, specific periods of rent that medicare was billed for these patients. Do not let on that you are gathering such data but collect as much as you can.
B. Any documentation or conversations held with management asking for any unsavory and illegal activities to be completed should be documented and forwarded to your own personal emails as well as paper copies kept for proof of said allegations.
C. Non Compete scare tactic is a ploy and has no bearing on pretty much every state in the US. PPS scares you with this so they have no immediete competition if you leave to a competitor.
D. Illegal/Non compliant activities to watch for: Titrations being completed to achieve saturations performed by non clinical staff. Mask fitting and CPAP set ups being performed by non clinician staff. For you drivers/sales reps out there, if you are being asked to perform said practices it against PPS accreditation filing. PPS files as a DME provider only not clinical services.
E. CA exemptee illegal practices: Are non exempt employees allowed access to the legend room? Are devices being pulled and distributed without proper log out by a designated center exemptee, if you answered yes please contact 916-650-6500
F. Contact ACHC with any illegal practices or non compliant situations that you notice or arise. You can contact them anonymously as well at 919-785-1214
G. Contact medicare whistleblowers, If I am correct any revenue recovered the whistleblower gets 30 %.
These are only a handful of the things that can be done if you really are concerned and want to make a difference. Understand that shutting PPS down completely will never happen but if you cripple enough centers by halting the illegal practices that are painted here it will cost them so many dollars that they will need to look at their practices. Each seperate investigation will take up PPS time and revenue, cause them to pay fines plus deal with any penalties that arise plus require them to provide services from other branches while said center is recooping. Medicare audits if found to be fruitful create large mass audits into a number of center records.
A. if you suspect fraudulent paperwork such as CMN, RX, etc, make copies of said paperwork for your own records. gather names of patients, people involved, specific periods of rent that medicare was billed for these patients. Do not let on that you are gathering such data but collect as much as you can.
B. Any documentation or conversations held with management asking for any unsavory and illegal activities to be completed should be documented and forwarded to your own personal emails as well as paper copies kept for proof of said allegations.
C. Non Compete scare tactic is a ploy and has no bearing on pretty much every state in the US. PPS scares you with this so they have no immediete competition if you leave to a competitor.
D. Illegal/Non compliant activities to watch for: Titrations being completed to achieve saturations performed by non clinical staff. Mask fitting and CPAP set ups being performed by non clinician staff. For you drivers/sales reps out there, if you are being asked to perform said practices it against PPS accreditation filing. PPS files as a DME provider only not clinical services.
E. CA exemptee illegal practices: Are non exempt employees allowed access to the legend room? Are devices being pulled and distributed without proper log out by a designated center exemptee, if you answered yes please contact 916-650-6500
F. Contact ACHC with any illegal practices or non compliant situations that you notice or arise. You can contact them anonymously as well at 919-785-1214
G. Contact medicare whistleblowers, If I am correct any revenue recovered the whistleblower gets 30 %.
These are only a handful of the things that can be done if you really are concerned and want to make a difference. Understand that shutting PPS down completely will never happen but if you cripple enough centers by halting the illegal practices that are painted here it will cost them so many dollars that they will need to look at their practices. Each seperate investigation will take up PPS time and revenue, cause them to pay fines plus deal with any penalties that arise plus require them to provide services from other branches while said center is recooping. Medicare audits if found to be fruitful create large mass audits into a number of center records.