CMS overpaid for CPAP supplies, says OIG

Tuesday, June 12, 2018

WASHINGTON – Most Medicare claims for CPAP supplies did not comply with Medicare requirements, according to a new report from the Office of Inspector General. Out of 110 sample claims that Medicare paid in 2014 and 2015, 24 complied with Medicare requirements while 86 claims with payments totaling $13,414 did not. The OIG estimates CMS made overpayments of almost $631.2 million as a result. CMS’s oversight is insufficient to ensures Medicare suppliers meet requirements. Without period claim reviews, contractors were unable to identify suppliers that consistently billed claims that did not meet requirements. The OIG recommends that CMS recover the portion of the overpayments of $13,414 associated with the 86 sample claims that are within the four-year reopening period; and work more closely with the four Medicare contractors. CMS concurred.