CMS says scammers are sending Medicare providers and suppliers phishing fax requests for medical records and documentation, falsely claiming to be part of a Medicare audit. This notice was posted on the CMS website:
“CMS has identified a fraud scheme targeting Medicare providers and suppliers. Scammers are impersonating CMS and sending phishing fax requests for medical records and documentation, falsely claiming to be part of a Medicare audit.
Important: CMS doesn’t initiate audits by requesting medical records via fax. Protect your information. If you receive a suspicious request, don’t respond. If you think you got a fraudulent or questionable request, work with your Medical Review Contractor to confirm if it’s real.”
Audits in the wound care space are ubiquitous and ongoing – usually focused on the use of “skin substitutes,” debridement charges and hyperbaric oxygen. You will almost always be notified in the form of an actual letter sent in the mail. A major problem is that the letter may be sent to one of many departments in the hospital/healthcare system administration, or sometimes to the office of a practitioner’s medical biller. The irony here is that it may be hard to find out about (and properly respond) to a real Medicare audit. Increased awareness of the audit climate could cause clinicians to be fooled by these scams. Watch out!
