Advanced Chiropractic Services Received Unallowable Medicare Payments for Chiropractic Services

Advanced Chiropractic Services (ACS) (based in Lawrence, Kansas) did not comply with Medicare billing requirements for 105 chiropractic service line items that we sampled. Specifically, the medical records did not support the medical necessity for any of the 105 sampled chiropractic service line items. On the basis of our sample results, we estimated that at least $737,000 of the $765,000 paid to ACS for chiropractic services in 2011 and 2012 was unallowable for Medicare reimbursement. These overpayments occurred because ACS did not have adequate policies and procedures to ensure that the medical necessity of chiropractic services billed to Medicare was adequately documented in the medical records.