OIG: Medicare paid $22.7M in improper payments for DMEPOS
By HME News Staff
Updated 9:41 AM CDT, Wed October 29, 2025
WASHINGTON - Medicare made $22.7 million in improper payments to suppliers for DMEPOS items provided to enrollees during inpatient stays that did not comply with requirements, according to a new report from the Office of Inspector General (OIG).
The OIG also found suppliers may have incorrectly collected up to $5.9 million in deductible and coinsurance amounts from enrollees or from someone on their behalf.
Additionally, the OIG found that system edits were not working properly prior to January 2020 and after CMS modified the edits in January 2020, improper payments substantially decreased. From January 2020 through December 2024, $4.5 million was improperly paid (about 20% of the $22.7 million). Because improper payments continue to be made, the OIG says further review of the edits may be necessary to determine whether refinements are needed.
The OIG made five recommendations, including that:
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CMS direct the DME Medicare contractors to recover from suppliers up to $22.7 million in identified improper payments and recommend that the suppliers refund to enrollees up to $5.9 million in deductible and coinsurance amounts.
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CMS review its system edits to determine whether any refinements are necessary to prevent improper payments to suppliers for DMEPOS items provided to enrollees during inpatient stays.
CMS concurred with four recommendations. CMS did not concur with the recommendation to review system edits.
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