Fraud and abuse costs American taxpayers more than $65 billion per year and consumes between 10%-25% of all health care costs. Fraud permeates every insurance line and is especially prevalent in workers compensation and Medicare.
Similar fraudulent patterns of practice and billing are seen in other healthcare insurance systems. One area that is especially prone to fraud and abuse involves “Physical Therapy” versus “Physical Therapist” practices. A great number of Medicare fraud prosecutions have emerged from treatment centers that do not employ licensed physical therapists. Assessment of provider credentials is a first step before one can determine if a treatment regime is consistent with practice standards. Physical therapists are ethically and legally bound to offer services within a range of professional practice guides and standards.
D+WC assists clients with the identification of and prosecution of suspected fraud and abuse. We literally have seen it all when it comes to aberrant provider behaviors. Our experts intimately understand community standards of care and practices that meet the threshold criteria for potential fraud & abuse. Our experts are experienced providers and expert witnesses who meet the requirements of the Daubert decision regarding presentation of medical evidence and the eight reliability factors regarding expert testimony. We back our professional opinions expressed in medical record reviews, independent examinations and case analysis through testimony.
D+WC aggressively educates clients to recognize patterns of fraud and abuse.