OIG report is ‘slap on the wrist,’ providers say

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Friday, December 15, 2017

YARMOUTH, Maine – A recent report on unlicensed suppliers receiving bid contracts re-opened old wounds for providers, who say it amounts to nothing more than a slap on the wrist for CMS.

In a November report, the Office of Inspector General found that CMS did not follow its own processes for the competitive bidding program, and, as a result, the agency awarded Round 2 contracts to 23 suppliers it shouldn’t have: 13 that did not meet licensure requirements and 10 to suppliers that did not meet financial requirements.

“How does this slip through the cracks and, now that it did, what are the penalties?” said Raymond Arthurs, owner of First Care Medical Supplies in Englishtown, N.J. “It makes no mention of them being excluded from the program.”

Instead, the report merely recommends that CMS follow its established procedures consistently; ensure that suppliers have the required licensure; and monitor supplier licensure requirements by implementing a system to identify potential unlicensed suppliers.

“It’s a slap on the wrist,” said Arthurs.

It’s especially frustrating for providers who followed all of the rules for the program—licensure, accreditation, surety bonds—as well as all of the other rules and requirements of operating as a Medicare supplier, and have found themselves not only shut out of the program, but also feeling like no one cares.

“The bottom line is, they screwed up,” said Bob Miller, who has closed his HME business, Hackettstown, N.J.-based Bach’s Home Health Care, after more than 30 years in business. “I think it’ still going on and AAHomecare should be all over this.”

In the past, AAHomecare has made more noise about licensure issues, but, given the size and volume of Round 2, errors are probably to be expected.

“Were there errors? Yes,” said Kim Brummett, vice president of regulatory affairs for the association. “Is it big enough, as another example (of a problem with the bid program)? Probably not. We will keep it in our arsenal.”

Comments

If an employee is found on the excluded list that's considered false claims and recoupment occurs on all tainted claims. BUT an unlicensed supplier operates their business without regard to the rules of the program and that's a simple mistake ! I don't get the priorities.