Former diabetes provider asked to repay $8 million

Sunday, February 17, 2008

WASHINGTON - Medicare is asking iCare, a former HME provider, to repay $8.2 million in overpayments for diabetic test strips and lancets.

The Jupiter, Fla.-based iCare received $8.6 million in 2002 and 2003, according to a report released in January from the Office of Inspector General (OIG).

Medicare conducted a review between August 2005 and September 2006, reviewing claims for a sample of 100 beneficiaries. The review found that none of the claims for those beneficiaries met Medicare requirements and that each claim had one or more errors, according to CMS.

Medicare covers up to 100 test strips and 100 lancets every month for insulin-treated diabetics and every three months for non-insulin treated diabetics. Medicare will cover higher amounts of supplies if the reason for higher quantities and the actual frequency of testing are documented in the beneficiary's medical record.

Among the errors found were:
* medically unnecessary supplies
* undocumented testing frequency
* unrequested shipment of supplies; and
* incomplete physician orders.

In an August 2007 letter to CMS, an attorney for iCare, which was sold to Owens & Minor in October 2005, disagreed with the findings, stating, in part that:

* iCare never shipped products without first obtaining a physician order.
* iCare never submitted claims for products it did not ship.
* iCare did not ship products if the beneficiary did not request product shipment; and
* iCare promptly refunded money to the beneficiary, as well as Medicare or other payers, for any product returned by the beneficiary.

The letter also said that since iCare is no longer in business, it does not have the resources or staff to review documents obtained by the OIG.

An attorney for iCare said any proceeds leftover from the sale of the company would remain in iCare's bank account and be used if necessary to repay any overpayments, according to the OIG report.

iCare had 30 days from the date of the OIG report to respond.