OIG: Medicare payments for CPAP ‘generally’ comply with billing rules
By HME News Staff
Updated 9:20 AM CDT, Tue April 28, 2026
WASHINGTON - Medicare payments made to suppliers for PAP devices generally complied with Medicare billing requirements, according to a new report from the Office of Inspector General (OIG).
For fiscal year 2017, the Comprehensive Error Rate Testing (CERT) Program determined continuous PAP (CPAP) devices had the second highest improper payment amount in the DMEPOS category, with estimated improper payments totaling $495 million for CPAP devices used for the treatment of obstructive sleep apnea (OSA).
The report found that:
- While Medicare payments to suppliers complied with Medicare billing requirements for 97 sampled PAP device claims, for the remaining 13 sampled PAP device claims, Medicare payments to suppliers did not comply with Medicare billing requirements. Specifically, Medicare made payments for PAP device claims that did not have the required documentation to support the services billed.
- In addition, some suppliers did not respond to OIG’s request for documentation to support the PAP device claims that were billed to Medicare.
The OIG recommended that CMS:
- Establish and implement internal controls to prevent improper payments for replacement PAP devices and provide outreach and education to suppliers on document requirements.
CMS did not indicate concurrence or nonconcurrence with the first recommendation. CMS concurred with the second recommendation and described steps it has taken and plans to take to strengthen supplier education.
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