Report Summary

Title: QTC Medical Services Complied with Medical Disability Examination Billing Requirements
Report Number: 19-08397-99 Download
Report
Issue Date: 3/16/2020
City/State:
VA Office: Office of Acquisitions, Logistics, and Construction (OALC)
Report Author: Office of Contract Review
Report Type: Review
Release Type: Unrestricted
Summary:

VA contracts for Medical Disability Examinations from non-VA medical sources on behalf of veterans and active military members. One of the companies VA contracts with to conduct these exams is QTC Medical Services (QTC).

The VA Office of Inspector General (OIG) and independent auditors have previously conducted reviews of QTC’s contracts, which identified significant questioned costs largely due to differences in Medicare billing rates and use of proprietary Medicare codes. Later reviews performed by independent auditors found additional deficiencies in subsequent QTC contracts. The OIG review could not determine if or how these were resolved with QTC.

This OIG review was conducted to ensure corrective measures to address prior identified issues were sustained and to follow up on recent billing practices. The review team focused on one of four contracts that VA awarded to QTC effective November 28, 2018, because the four contracts were identical except for geographical coverage. The OIG team sampled two months of billings totaling more than $12 million under the selected contract. This review focused on two issues found to be of concern in previous reviews:

1. Contract overbilling

2. National Correct Coding Initiative (NCCI) edits to prevent duplicate billing

The review resulted in no negative findings or recommendations. The OIG review team concluded that QTC adequately followed billing requirements for the contract and did not materially overbill VA for services rendered through February 28, 2019. VA’s Office of Acquisition, Logistics, and Construction commented in its review of the report, “OALC appreciates this follow-up review. It demonstrates that our corrective actions were successful and fully integrated into VA practices….”