COLUMBUS – A Lewis Center durable medical equipment company has reached a settlement with the Ohio Bureau of Workers’ Compensation and Attorney General Mike DeWine’s office in a case involving improper billing of services and products provided to Ohio injured workers. Modern Medical, Inc., an intermediary between other durable medical equipment companies and injured workers, agreed to repay $400,000 last week to settle the four-year old case.
“It’s unbelievable, and unacceptable, that any firm in business to assist injured workers would turn around and abuse the very system designed to help those workers,” said BWC Administrator/CEO Stephen Buehrer. “Employers pay into the State Insurance Fund to support workers who have been injured on the job, not to direct unearned profits to other businesses.”
In early 2007, BWC’s Special Investigations Division (SID) discovered that Modern Medical was excessively billing BWC for durable medical equipment through the Healthcare Common Procedure Coding System (HCPCS). SID started the review of billing practices and identified improper billing submitted to BWC, including double billing for durable medical equipment supplies, unbundling of equipment, and billing for accessories that were provided at no cost by the manufacturer.
It was later discovered Modern Medical was also inflating billing of its home health services by using multiple HCPCS codes to bill for the same service and improperly billing BWC for services related to transporting injured workers.
“This is great news for Ohio’s injured workers and the state’s employers. Working with the BWC, we were able to recover funds that can be used the way they were intended, to help those in need,” said Attorney General DeWine, whose office assisted in the case.
On September 7, 2011, Modern Medical agreed to pay $400,000 for inflated and improper billing. Modern Medical will also be required to hire a monitoring company for a three-year period of time to review future billings submitted to managed care organizations and to submit audit reports to BWC.
Source: Ohio BWC