<http://www.MedicalNewswire.com> Search The Archives home <http://www.medicalnewswire.com/index.asp> | subscribe <http://www.medicalnewswire.com/subscribe/> | issue <http://www.medicalnewswire.com/archive/issue.asp> | channels <http://www.medicalnewswire.com/02.asp> | clients <http://www.medicalnewswire.com/clients.asp> | rates <http://www.medicalnewswire.com/04.asp> | contact <http://www.medicalnewswire.com/06.asp> | archive <http://www.medicalnewswire.com/archive/> Friday, November 30, 2001 Headlines Subscribe <http://www.medicalnewswire.com/subscribe/> Providers Can’t Shop Around For Carriers Why Bother With Medicare Repayments Kickbacks Lead To Jail For Hospital Doc And VP Relaxation Therapists Want Medicare Coverage Providers Can’t Shop Around For Carriers DENVER, CO (Medical Newswire) Health care companies that operate in multiple states can't pick and choose which Medicare contractor to submit their claims to, as a Teterborough, NJ-based clinical lab recently learned the hard way. According to Colorado U.S. Attorney John Suthers, Quest Diagnostic Inc. Nov. 21 agreed to pay more than $350,000 to settle a 1998 qui tam case filed by the former controller of its Billings, MT lab. Whistleblower Donna Scott accused Quest of attempting to boost its Medicare reimbursement by improperly exploiting variances in different carriers' fee schedules. In particular, Quest allegedly submitted claims to the Colorado carrier that ought to have been sent to carriers in New Mexico and Utah. In 1998 and 1999, after an internal investigation, Quest had come forward with certain claims that ought to have been submitted to the Utah carrier, but actually were submitted in Colorado. At that time, the company returned more than $120,000 to Medicare, based on the difference between the Utah and Colorado fee schedules for certain diagnostic testing services. The Nov. 21 settlement brings the total value of the contractor snafu to $475,000. Scott will collect a $71,100 bounty for her role as whistleblower. top Why Bother With Medicare Repayments RESEARCH TRIANGLE PARK, NC (Medical Newswire) The debate on overpayments is roiling on Capitol Hill, as Congress debates new policies that could keep CMS from demanding repayment while a provider appeal is in the works. Some proposals would allow repayment over extended periods of time in cases of severe financial hardship. And other changes may be on the way… That's why you need our experts to guide you through the minefield of handling overpayments. Assuming that inconsistencies will always “come clean in the wash” can be a grave mistake, says Ankur Goel, a partner with Washington-based McDermott, Will & Emery. “At the same time, the government is considering provisions that will spell relief for some providers,” adds attorney Heidi Kocher with Brown & Fortunato in Amarillo, TX. Goel and Kocher will help you find the strongest financial ground - while remaining compliant - at Eli Research’s audio seminar, “Medicare Repayments: Whether, When and How to Make Them.” The conference will take place on Tuesday, Dec. 11, 2001 from 1 to 2:30 p.m. “This realistic approach will get all your decision-makers on the same, correct page,” comments Goel. Program highlights include seven tough questions you must answer before making the decision to repay; how to distinguish between situations calling for repayments and those requiring disclosures; an in-depth exploration of the mechanics of repayments; and practical tips for integrating repayment and disclosure decisions into your compliance plan. “We’ll show you how to make good decisions during the repayment process,” promises Kocher. Nursing home administrators will earn CEU’s at this seminar. For more information about registration and pricing, call 1-800-874-9180 or visit: * http://www.eliresearch.com/repayments.html top Kickbacks Lead To Jail For Hospital Doc And VP CHICAGO, IL (Medical Newswire) The long-running kickback probe of Chicago's troubled Edgewater Medical Center tallied prison terms for a physician and the facility's former senior vice president Nov. 28. A federal district court judge sentenced Roger Ehmen to 6 1/2 years in prison and Dr. Ravi Barnabas to a term of 52 months for their roles in a health care fraud scheme, the Chicago Tribune reports. The ploy involved the payment of kickbacks to physicians in exchange for referrals of patients to Edgewater for hospital care - care that in many cases wasn't necessary, prosecutors say. Ehmen also was ordered to pay $5 million in restitution, according to the Tribune; Barnabas must pay $1.1 million. top Relaxation Therapists Want Medicare Coverage SOUTH BEND, IN (Medical Newswire) Learning how to lead a more relaxed life may be a key part of recovering from cardiac illnesses, but should Medicare pay for relaxation lessons? That question may be answered by a new study on the effects of relaxation therapy on cardiac patients, according to the South Bend Tribune of South Bend, IN. Three medical centers in California, Indiana and Pennsylvania are participating in the study, in which patients who have been treated for heart attacks and coronary artery blockages will receive lessons in exercise, nutrition and relaxation as part of their rehab. The patients will work out in an exercise room, then lie on mats and listen to classical music or the sounds of ocean waves. Following this relaxation exercise, they’ll take nutrition classes. Proponents of this mind/body approach hope to yield quantitative evidence with which to sway the Centers for Medicare & Medicaid Services into covering relaxation therapy services. top Send This Issue Of MEDICAL NEWSWIRE To A Colleague E-mail: Limited Time Offer! Sign up to receive Medical Newswire FREE at www.MedicalNewswire.com <http://www.medicalnewswire.com> . Copyright © 2001 Medical News Wire 2327 Englert Drive, Suite 202 Durham, NC 27713. You have permission to forward Medical Newswire, in its entirety only, to your colleagues, provided the copyright notice remains part of your transmission. All other rights reserved. For questions or comments regarding story content, e-mail editors@newsmailnet.com <mailto:editors@newsmailnet.com> . For free subscription information, visit www.eliresearch.com <http://www.eliresearch.com/> , e-mail subscribe@newsmailnet.com <mailto:subscribe@newsmailnet.com> or call (800) 874-9180. 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