Inspector General Sets 2005 Work Plan

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Sunday, October 17, 2004

October 18, 2004

WASHINGTON  - The OIG plans to investigate whether Medicare pays too much for enteral nutrition, home respiratory therapy and power wheelchairs,  according to its 2005 work plan, which was released last week.
According to the 2005 work plan, the OIG hopes to determine the appropriateness of Medicare payments for these items and assess whether the suppliers’ documentation supports the claim, whether the item was medically necessary, and whether the beneficiary actually received the item.
Power wheelchairs, enteral nutrition and oxygen equipment and supplies will also be studied to establish a comparison between Medicare rates and other federal and state programs, and with wholesale and retail prices.
Both of these DME projects were previously included in the 2004 Work Plan, according to AAHomecare.
The OIG also intends to conduct several reviews on the average sales price (ASP) reimbursement model that is set to begin on January 1. The studies include an examination of the methodology manufacturer’s use to compute the ASP and CMS’s collection and maintenance of ASP data.
The OIG’s complete 2005 work plan is available to view at http://www.oig.hhs.gov/publications/docs/
workplan/2005/2005%20Work%20Plan.pdf.

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