OIG: spike in claims for non-mail order diabetes supplies

Thursday, November 8, 2012

WASHINGTON – Claims for more expensive, non-mail order diabetes test strips (DTS) increased 33% from 2010 to 2011, while claims for less expensive, mail order DTS decreased 71%, according to a study by the Office of Inspector General (OIG). Under Round 1 of competitive bidding, non-mail order DTS are reimbursed at a rate more than double that of mail order DTS, creating what the OIG calls a “financial incentive to bill for non-mail order DTS.” The OIG reviewed 2010 and 2011 Medicare claims data and conducted telephone interviews with 211 beneficiaries. It found that 20% of those beneficiaries were improperly billed, which, according to the study, contributed to the increase in claims for non-mail order DTS. Additionally, the study found that 23% of beneficiaries reported what the OIG deemed inappropriate supplier activities, such as waiving copayments and sending unsolicited DTS.

Full OIG study: https://oig.hhs.gov/oei/reports/oei-04-11-00760.pdf