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Certificate of Medical Necessity Fraud

CMN is a form that is signed by a physician to substantiate the medical necessity of an item of durable medical equipment furnished to a Medicare beneficiary. It contains far more details than a prescription, and DME suppliers must have it in their possession prior to submitting a claim to Medicare. The document not only indicates specific medical conditions, but details certain diagnoses, and the length of time the product is to be used. Fraud often occurs with unscrupulous providers forging CMN’s and/or providing kickbacks to physicians in exchange for their signatures.

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