Medicare, HME reach new low

 - 
09/24/2008

Claims for glucose test strips for patients whose diagnosis codes listed them as having breathing problems, bubonic plague, leprosy and impotence?

So reads another report released today by the Senate Permanent Subcommittee on Investigations. Investigators looked at medical equipment claims submitted between 1995 and 2005 and found $4.8 billion in Medicare payments for bills submitted with codes that were invalid or blank.

Some bills featured smiley faces or exclamation points instead of proper coding. But guess what? They were still paid.

A CMS official told USA Today that the agency addressed this "vulnerability" five years ago. Investigators acknowledged that spending on claims paid with invalid codes fell dramatically after 2003. They still topped $23 million from 2004 to 2006, though.

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The report is the third in a series of reports by the subcommittee on medical equipment.

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