OIG issues mid-year update
WASHINGTON – Power mobility devices and orthotic braces are among the product categories under review by the Office of Inspector General, according to a new report.
The OIG released its Mid-Year Update for 2016 on June 7.
Necessary and compliant
The OIG will perform several reviews to determine whether claims were medically necessary and compliant with Medicare requirements. Affected product categories include orthotic braces, nebulizers and related drugs, and power mobility devices.
The OIG will conduct a review to determine the effectiveness of system edits to prevent inappropriate payments for diabetes test strips and lancets to multiple suppliers. Prior OIG work found that inappropriate payments were made to multiple suppliers for test strips and lancets dispensed to the same beneficiary with overlapping service dates.
Power mobility devices
The OIG will conduct a review to determine whether potential savings can be achieved if certain power mobility devices are rented over 13 months rather than acquired as a lump-sum purchase. The Affordable Care Act eliminated the lump-sum purchase option on Jan. 1, 2011, but only for standard power wheelchairs.
The OIG will describe billing trends for vents, respiratory assist devices and CPAP machines from 2011 to 2014, and examine factors associated with the increase in billing for vents. The OIG will also examine the impact of the competitive bidding program on billing trends for vents.
The OIG will also perform a mandatory review of CMS’s competitive bidding process.