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Medicare Fraud

kotabear kotabear (New) New

I work for a company where the MDS nurse is back dating their MDS assessments. Is this Medicare fraud?

I would not get involved with this situation if you do not have MDS duties.

labordude, BSN, RN

Specializes in L&D, OBED, NICU, Lactation.

Your response is to bury their head in the sand because "it's not their job"?! That really deserves a SRSLY?!

This poster is absolutely right to question if the reviewer is backdating because backdating is NOT ALLOWED. If there is a question at all of fraud, contact your compliance department. Most of them have anonymous lines if you are not comfortable reporting your name. That being said, you could also ask the person directly about the dates they are writing on the assessments. If you are not satisfied with their answer to the extent you are 100% sure there is no fraud, contact compliance anyway.

Employees who go around meddling and making accusations that are not backed up with facts, often find themselves jobless and lacking when it comes to getting the next job. If this person has FACTS pursuant to their day to day duties, then by all means, report the wrongdoing to the proper authorities. But don't think that going around making unfounded accusations is going to go over well. Whistleblowers have to be prepared for all contingencies.

Employees who go around meddling and making accusations that are not backed up with facts, often find themselves jobless and lacking when it comes to getting the next job. If this person has FACTS pursuant to their day to day duties, then by all means, report the wrongdoing to the proper authorities. But don't think that going around making unfounded accusations is going to go over well. Whistleblowers have to be prepared for all contingencies.

I understand what you are saying and it contains some sage advice.

Respectfully, this post didn't actually make any unfounded accusations but did ask about a practice that is presumably observed behavior. Asking questions relative to concerns about fraud ought to be acceptable, IMV.

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