CMS: $6.4B in improper payments to DMEPOS in 2012

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Thursday, October 3, 2013

WASHINGTON – The improper payment rate for DMEPOS in 2012 was a whopping 66%, according to a new report released by CMS. Of the $9.7 billion Medicare paid for DMEPOS in 2012, $6.4 billion was improper, the report states. Across Medicare, the improper payment rate was 8.5%, representing $29.6 billion. That means DMEPOS, which represents about 2.8% of all Medicare fee-for-service expenditures, accounted for 19.8% of the overall improper payment rate, the report states. The vast majority of improper payments identified for DMEPOS were due to insufficient documentation (94.2%). About 4.2% of the improper payments were classified as errors in medical necessity. Oxygen supplies and equipment, glucose monitors, and nebulizers and related drugs had the highest incidence of improper payments, accounting for about 45.8% of improper payments for DMEPOS, according to the report.