As part of its investigation, the GAO "used publicly available guidance to attempt to create DMEPOS suppliers, obtain Medicare billing numbers and complete electronic test billing." It succeeded in Virginia, setting up a sham operation that "would have been clear to bill Medicare...for potentially millions of dollars worth of nonexistent supplies."
The industry has long argued that CMS needs to do a better job creating barriers to entry for the DME industry. Now it has the GAO, an independent government body, echoing its call.
But industry stakeholders say they'll keep the, "We told you so," to a minimum. They want to use the report as a launching pad to have conversations not only with CMS but also with legislators about how to improve the enrollment and inspection process.
On another fraud note, the Miami Herald today published an article with this headline: "A former scam artist tells how it works: Angel Castillo Jr., a convicted trafficker who found his calling in healthcare fraud, offered an inside look at Medicare corruption in Miami-Dade." Unbelieveable!