Posted on September 3, 2018 at 3:00 AM
When Medicare agreed to cover Screening for Lung Cancer with Low Dose Computed Tomography (LDCT), it required that the clinician and patent first have a “shared decision making, including the use of one or more decision aids.”
But in a new study, researchers found that zero physicians providing LDCT had a qualifying shared decision making visit with an evidence based decision aid. “Potential harms of screening were not adequately explained, and decision aids were not used.”
It seems that the studied clinicians have committed healthcare fraud. They have billed Medicare for services without satisfying a necessary condition for payment. The USDOJ, HHS OIG, or private qui tam relators may want to look into this.