Is CMS *really* serious about saving money?

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09/15/2011

Managing Editor Theresa Flaherty and I had an interesting conversation after we posted to our website this story about how CMS has failed to use the surety bond requirement to recover erroneous payments.

I probably don't need to remind you that in October 2009 CMS started requiring that HME providers obtain surety bonds of at least $50,000. Apparently, CMS has drafted procedures for recovering payments through surety bonds but the agency claims "significant personnel changes" have prevented it from finalizing them.

So two years have gone by since the requirement was implemented and not $1 has been recovered.

Hmph.

CMS may be a government agency, but the agency does have a boss. He's called Congress and if I were him I'd be pissed.

I will remind you that the surety bond requirement was mandated in the Balanced Budget Act of 1997?!?! (Sorry, I don't usually use exclamation points in my professional writing, let alone a string of exclamation points and question marks, but I thought it was warranted in this case.)

I mean, Congress may be the government, but it does have a boss. She's called a taxpayer and I am her, and I'm pissed.

Why, oh why, do these things take so long?

In the meantime, because CMS has dragged its feet on using surety bonds to recover erroneous payments, which, when you think about it is one of the more reasonable fraud and abuse measures, Congress has directed the agency to sick an army of contractors and auditors on providers to review documentation and pay them based on the errors they find and the overpayments they collect.

This brings me back to my conversation with Theresa. She said something to the effect of, "What if CMS didn't recover any erroneous payments, because it didn't find any?"

That's the whole point: The sad thing is, CMS doesn't even have the procedures in place to find out.

The OIG's a little perturbed about this, too. It plans to work on a study to determine: the number of suppliers with outstanding un-recovered payments since the surety bond requirement was implemented, and the amount of these overpayments.

That'll be interesting.

Liz Beaulieu