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A Queens Chiropractor Received Improper Medicare Payments for Chiropractic Services

Nearly all Medicare Part B payments to a chiropractor in Queens, New York, did not comply with Medicare requirements. Specifically, 95 of 100 sample claims for which the chiropractor received Medicare Part B reimbursement did not comply with Medicare requirements. These improper payments occurred because the chiropractor did not have any policies and procedures to ensure that chiropractic services provided to Medicare beneficiaries were medically necessary and sufficiently documented.

On the basis of our sample results, we estimated that the chiropractor improperly received at least $518,000 in Medicare reimbursement over a 2-year period.