RE:VIEMED PROVIDES UPDATE CONCERNING SUCCESSFUL APPEAL OF OIGI understand that VMD also disputes
1. the method of selecting the 100 random samples.
2. the use of extrapolation.
3. the lack of medical expertise of Maximus vs the opinion of the 89 different physicians who prescribed the treatments
My sense is that winning the appeal at this stage has changed the nature of the dispute. While the OIG's finding of a 98% overbilling rate carried with it a taint of unnlawfulness, the appeal ruling's finding has changed that. Now, the dispute is more about conflicting CMS guidelines and a deeper dive into the medical evidence required to document the necessity of treatment delivered by Viemed.
The passage of time and the increased number of studies demonstrating the efficacy of NIVs will assist in any future reviews. The studies now show that the OIG's medical biases would have resulted in patient deaths and increased costs. That will be hard to justify should the appeals continue to the courts and a judge has to weigh OIG's medical opinion against the opinion of the 89 different physicians.
It comes down to Viemed trying to save lives and comply with confused CMS guidelines vs. OIG trying to save money on technicalities of documenation despite medical opinions of 89 different physicians.
This dispute will end in Viemed's favour. IMHO