MEDICARE/CMS FIGHT!

Keith Crownover, BS,CPO,BOC(po)

Description

Title:

MEDICARE/CMS FIGHT!

Creator:

Keith Crownover, BS,CPO,BOC(po)

Date:

7/6/2005

Text:

For those who are truly serious about holding CMS/Medicare and specifically
Region C accountable for their actions and inactions, NOW is the time!

We have located an attorney whom specializes in Health care law. He is
currently researching the feasibility of filing a Class action suit against
CMS/Palmetto/Region C Medicare. In order to determine whether a class
action suit can be certified and initiated we need ALL individuals who
desire involvement AND have credible evidence of wrong doing to come
forward ASAP!

If you as a practitioner and/or your practice has suffered delayed
payments, repeated denials or any type of tangible fiscal damage in the
pursuit of providing care for Medicare recipients we would like to hear
from you. Understanding that these accusations must accompany properly
submitted, legitimate, correctly filed documentation (please do not send
any claims or patient documents). However, if you believe your claims have
been delayed, denied or rejected due to constant vacillation of CMS policy
and procedures and can demonstrate a pattern of such, this too may be a
cause of action.

We are in need of as many complainants as possible who have tangible,
factual proof of CMS/Medicare/ Region C^Òs violations. We need: specific
examples of inappropriate behaviors; types of claims, L-codes delayed
and/or rejected; numbers of claims filed with a particular code or claim
rejected and/or delayed; percentages of problem claims and/or codes;
numbers of denials and/or delays, quantified over specific segments of time
(within the past 6 months, 12 months, etc.) Feel free to submit any
further problematic areas regarding consistent problems in Medicare
reimbursement you or your practice has suffered. Please remember HIPPA
regulations and do not submit any personal information. Problems, time
frames, numbers, dollar amounts lost in denials and/or appeals and
percentages of problematic(denied, rejected, delayed past 90 days, etc.)
claims will suffice at this point.

Once our evidence is collected and presented to the firm, they will
determine if we can and should proceed with a class action, individually
file suit, or decline representation. Obviously a law firm will not accept
a case on contingency unless they see a substantial pay day and/or
publicity likely to produce revenue. If we offer a retainer, then
collective damages can be a smaller sum and the firm will accept the case.
>From what we have experienced and from speaking with a number of our
colleagues out there, I see no reason why we cannot all join together,
provide indisputable evidence of egregious acts, numbering at least in the
hundreds of thousands of dollars, and together hold CMS/Medicare and
specifically Region C responsible for that which it has done!

Ladies and Gentlemen, the time has come for real action. Make no mistake,
this will be a fight and each must decide for him/herself whether to take a
stand and have a chance to make a real difference or passively stand by and
wait. We certainly are very aware that seeing actual monies is a distant
reality if one at all. But we must try, we must be heard! If the final
outcome equates to changes that benefit recipients as well as providers,
then it will all be worth while. These stark realities sting more than a
little. As we are legitimately owed thousands for items provided and been
seriously financially damaged to the brink of bankruptcy due to
Medicare/CMS/Region C. I firmly believe that there is a real civil case
here and the initiation of such may bring about investigations that prove
federal breech of law. With or without my colleagues, my resolve shall
remain in tact. Although, there is strength in numbers and every provider
that has been damaged and hindered should be fairly compensated and justice
should be done for all of us!

Please disseminate this communiqué to every facility and publish in every
way available. I need to have all evidenced gathered by 07.31.05. Please
email: <Email Address Redacted> , Fax: 405.621.9986, or send to: Advanced Orthotic
Prosthetic Tech., LLC, 5601 NW 72nd #308, Oklahoma City, OK 73132 all above
outlined factual evidence. Again, specific clear facts, number of problem
claims within a specific time frame, percentages of problems,monies lost
are very needed at this time.

Keith Crownover,BS,CPO,BOC(po)

                          

Citation

Keith Crownover, BS,CPO,BOC(po), “MEDICARE/CMS FIGHT!,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225145.