If you are practicing in Florida, New York or California and treat Medicare patients then be on the lookout for a letter from one of Medicare’s outside contractors telling you that you have been chosen for an audit (AKA post payment claim review).

In one such letter being sent to chiropractors Strategic Health Solutions starts out by telling you how Medicare is striving to reduce improper payments.

Who could be against that – right?

Then they go on to tell you the reason they selected you. And by the way it’s the same reason they selected everybody. 

They blame it on the Office of the Inspector General who urged: 

“CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services”.

This is because the OIG found a whopping $76 million in Medicare payments to chiropractors were “questionable”. I’ll let you look up what percentage of all Medicare money is paid to chiropractors versus medical providers and let you decide why taxpayer money is being spent going after chiropractors. 

You can also review a detailed evaluation of the OIG report I did where I outlined the absurdity of the OIG report and its findings. Bear in mind that one of the things we found out through a Freedom of Information Act (FOIA) request to the OIG was that they would not reveal who the chiropractors were that they used to review the claims that determined that all this fraud was going on. And that is just one of many requests we had that they denied.

So much for Freedom of Information.

The key here is that they are targeting chiropractors in high fraud areas, those that see a high volume of Medicare and those that have some “history” with Medicare. That history is the key. For example, if you get a denial from Medicare and do not appeal it then this raises a red flag for them and you will be on their radar.

If you do get a letter from Medicare or one of their for-profit “partners” be sure to respond on time and be sure to notify us. 

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