NCB: 'Red flags' cause delay

Thursday, October 28, 2010

WASHINGTON - HME providers now have an idea why CMS is dragging its feet in releasing the names of the winning bidders. During an Open Door Forum Oct. 14, a CMS official told listeners that the agency has tested a new program integrity tool on the winning bidders and has identified "a number of red flags" that require further examination. "Given the past history of fraud in the DME arena, especially in Miami, CMS believes that it is prudent to take the time to review these issues to ensure the program is best positioned to service Medicare beneficiaries," said Michael Keane of the Division of DMEPOS Competitive Bidding, Chronic Care Policy Group. Originally, CMS planned to release the names of the winning bidders in September. Keane told listeners that the delay would be short-lived. "We expect to move forward with the implementation of the program very soon, beginning with the announcement of the contract suppliers and continuing our aggressive education and outreach activities for our beneficiaries and other stakeholders," he said.

Fraud program gets double the funding

WASHINGTON - CMS announced in September $9 billion in grants to help more than 50 Senior Medicare Patrol (SMP) programs fight Medicare fraud. The award, which doubles the SMP's funding, is part of the president's mandate to educate seniors and other Medicare beneficiaries about how to prevent Medicare fraud. The SMP volunteers work in their communities to educate Medicare and Medicaid beneficiaries, family members and caregivers about the importance of reviewing their Medicare notices to identify billing errors and potentially fraudulent activity. In 2009, more than 3,000 beneficiary complaints involving potential fraud were handled by the SMPs.

DME MAC cashes in

BALTIMORE - CMS has tapped National Government Services, a subsidiary of WellPoint, to continue on as the DME MAC for Jurisdiction B, it was announced in September. The value of the new contract, which consists of a base year and four, one-year options: $86.7 million.

GAO plans new report on oxygen

WASHINGTON - The Government and Accountability Office (GAO) plans to publish a report on the cost of providing home oxygen therapy, AAHomecare announced in September. The GAO asked AAHomecare to review and comment on the draft report, but it asked the association not to discuss the details. The GAO expects to publish the report in November.