OIG: Medicare still vulnerable to fraud

Sunday, April 1, 2007

WASHINGTON - A recent inspection by the Office of Inspector General (OIG) revealed that 45% of DMEPOS suppliers in South Florida did not comply with at least one of the five standards reviewed.

The report, "South Florida Suppliers' Compliance With Medicare Standards: Results From Unannounced Visits," contains the findings of site visits to providers in Miami-Dade, Broward and Palm Beach counties. These counties were targeted for review based on previous allegations of supplier noncompliance with Medicare standards.

Working with CMS and the National Supplier Clearinghouse, the OIG inspected 1,581 suppliers to assess their compliance with selected Medicare supplier standards. The OIG focused on five specific requirements, which state that suppliers must: (1) maintain a physical facility, (2) be open and staffed during business hours, (3) have a visible sign, (4) post hours of operation, and (5) maintain listed telephone numbers.

According to the report:

* 31% percent of suppliers did not comply with the first two requirements of maintaining a facility at the business addresses that they provided to Medicare and being open for business during posted hours.

* Another 14% of the providers were open but failed to meet at least one of the three remaining requirements that OIG reviewed.

"It is clear that Medicare continues to be highly vulnerable to DMEPOS fraud and abuse," said Inspector General Levinson. "It is vital that we protect Medicare beneficiaries from unscrupulous suppliers who are gaming the system at the expense of our nation's seniors and taxpayers."