First Coast Service Options, Inc.: Audit of Medicare Claims by Podiatrists and Optometrists for Comprehensive Nursing Facility Assessments for Calendar Years 1995 through 1998

EXECUTIVE SUMMARY:

This final audit report presents the results of our audit of claims by podiatrists and optometrists for comprehensive nursing facility (CNF) assessments during Calendar Years 1995 through 1998. We found that Florida podiatrists and optometrists inappropriately billed Medicare for CNF assessment services totaling $3,224,389 and $68,740, respectively. First Coast paid $1,979,769 and $46,372 for their claims. We made no recommendations because First Coast initiated corrective action prior to the issuance of our report. First Coast issued a reminder to podiatrists and optometrists not to bill for any service they are not licensed to perform, and implemented computer edits to prevent payment of CNF assessments claimed by podiatrists and optometrists. First Coast agreed with the accuracy of our report.