OIG reminds DMEs: Don’t cold call beneficiaries

Monday, March 31, 2003

WASHINGTON - The OIG issued a fraud alert last month, warning providers about something they should already know: It’s not OK to hire telemarketers to make unsolicited telephone calls to Medicare beneficiaries and try to sell them DME.

“It might be common knowledge, but apparently it is being done,” OIG spokesperson Judy Holtz told HME News.

Industry sources say the OIG has begun investigating a number of companies for the infraction, but Holtz declined comment on that speculation.

To help ensure that Medicare beneficiaries aren’t pressured into buying items they don’t need - and that taxpayers aren’t stuck paying for - DMEs can’t making unsolicited telephone calls to Medicare beneficiaries regarding the furnishing of a covered item, except in three specific situations: (i) the beneficiary has given written permission to the supplier to make contact by telephone; (ii) the contact is regarding a covered item the supplier has already furnished the beneficiary; or (iii) the supplier has furnished at least one covered item to the beneficiary during the preceding fifteen months.

In its March 3 alert, the OIG stated that it had “credible information that some DME suppliers continue to use independent marketing firms to make unsolicited telephone calls to Medicare beneficiaries to market DME. Suppliers cannot do indirectly that which they are prohibited from doing directly.”

“They must have some very specific complaints because that rule has been on he books for a long time,” said Asela Cuervo, AAHomecare’s sr. vp of government relations. “I hope people understand what they can and can not do.”

If a claim is submitted for items or services generated by a prohibited solicitation, the DME and the telemarketer are potentially liable for criminal, civil and administrative penalties for causing the filing of a false claim. HME