OIG to CMS: Reduce payment errors for DME repairs

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Thursday, August 12, 2010

WASHINGTON - Medicare allowed nearly $29 million for questionable repair claims for capped rental DME in 2007, according to a report released last week by the Office of Inspector General (OIG).

Other findings in the report:

*    In 2007, Medicare allowed nearly $27 million for repair claims of beneficiary-owned capped rental DME that failed to meet payment requirements.

*    From 2006 to 2008, Medicare erroneously allowed nearly $4.4 million for repairs for beneficiary-rented capped rental DME.

*    From 2006 to 2008, Medicare erroneously allowed $2.2 million for routine maintenance and servicing of capped rental DME with rental periods after implementation of the Deficit Reduction Act.

In addition to reviewing claims, OIG officials spoke with beneficiaries and found that some suppliers failed to properly customize power mobility devices, rendering the devices useless, and that some suppliers did not offer loaners when repairing devices, leaving some beneficiaries immobile.

In light of its findings, the OIG made the following recommendations to CMS:

*    Implement an edit to deny claims for routine maintenance and service of capped rental DME with rental periods beginning after Jan. 1, 2006.

*    Implement an edit to deny claims for repair of beneficiary-rented capped rental DME.

*    Improve enforcement of existing payment requirements for beneficiary-owned capped rental DME.

*    Consider whether to require MACs to track accumulated repair costs of capped rental DME.

*    Develop and implement safeguards to ensure that beneficiaries have access to the services they require; and

*    Take appropriate action on erroneously allowed claims for maintenance and service.

To read the full report, go to http://oig.hhs.gov/oei/reports/oei-07-08-00550.pdf.

 

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