OIG to Pos-T-Vac: 51% of claims were no good

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Tuesday, June 19, 2012

DODGE CITY, Kan. – The Office of Inspector General (OIG) this week recommended that Pos-T-Vac Medical, a manufacturer and supplier of male vacuum erectile systems, refund $4.2 million to Medicare for claims that should not have been allowed.

The OIG reviewed 100 claims and found that 51 claims worth $18,007 did not comply with documentation requirements. It then extrapolated those results to all claims submitted from Jan. 1, 2008, through Dec. 31, 2009.

Medicare paid Pos-T-Vac $8.5 million for male vacuum erectile systems in 2010, the most of any provider, according to the HME Databank. In all, it paid providers $47.1 million for the systems that year.

In addition to a refund, the OIG recommends that Pos-T-Vac develop and implement policies and procedures to help ensure that it collects and maintains the required documentation.

The OIG noted the following deficiencies in Pos-T-Vac’s documentation: For 50 claims, it did not maintain proof of delivery in its files; for two claims, it did not maintain sufficient documentation of patient medical condition to substantiate necessity; and for one claim, it lacked the signature of the treating physician in a written order.

To read the OIG’s report, go to http://oig.hhs.gov/oas/reports/region7/71105016.pdf.