This report is a consolidation of findings since 2000 related to Medicare’s chiropractic improper payments. The two main issues involve improper payments and chiropractic fraud.
In summary, CMS controls do not prevent improper payments and has shelled out billions since the new millennium. In addition, OIG has completed investigations where chiropractors submitted claims without providing services, unnecessary services, or falsified patient records that have resulted in 11 incarcerations. From 2005 to 2016, OIG excluded 542 chiropractors from Medicare for various periods.
OIG says if Medicare established a ‘medical review threshold’ for Chiropractic Services, CMS could save millions by reducing improper payments for medically unnecessary services without cutting access for necessary services.Read the full report