Tag: Office of Inspector General (OIG)
In brief: MA fraud, Abbott settlement, MiniMed separation, SoClean commercial
September 16, 2026HME News Staff
WASHINGTON – The Office of Inspector General (OIG) says it has identified gaps in the screening process for fraudulent DMEPOS suppliers in Medicare Advantage.
The agency issued a report on Sept. 9 saying Medicare Advantage organizations (MAOs) conduct some screening checks on in-network suppliers but fewer checks of out-of-network suppliers. It also says:
The Centers for Medicare & Medicaid Services (CMS) does not screen all DEMPOS suppliers before they bill Medicare Advantage because...
OIG to CMS: ‘Medicare Advantage is also at risk’
September 14, 2026HME News Staff
WASHINGTON – The Office of Inspector General (OIG) says it has identified gaps in the screening process for fraudulent DMEPOS suppliers in Medicare Advantage.
The agency issued a report on Sept. 9 saying Medicare Advantage organizations (MAOs) conduct some screening checks on in-network suppliers but fewer checks of out-of-network suppliers. It also says:
The Centers for Medicare & Medicaid Services (CMS) does not screen all DEMPOS suppliers before they bill Medicare Advantage because...
OIG opinion puts spotlight on referral management software
August 21, 2026Liz Beaulieu, Editor
WASHINGTON – A recent Office of Inspector General (OIG) advisory opinion found that a home health provider's use of referral management software could violate the federal Anti-Kickback Statute. It has home medical equipment (HME) providers reviewing their own contracts, says health care attorney Jeff Baird.
"We have received many phone calls from DME suppliers asking about these contracts," said Baird, chairman of the Health Care Group at the Amarillo, Texas-based Brown & Fortunato.
The...
In brief: Medicare fraud fight, Inc. 5000 appearances, CRT Awareness Week
August 21, 2026HME News Staff
WASHINGTON – A new Office of Inspector General (OIG) white paper warns that durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) fraud continues to cost Medicare and taxpayers millions of dollars annually despite increased oversight efforts.
The paper, “The Nation’s Challenge to Combat Durable Medical Equipment Fraud in Medicare,” focuses on three elements that bad actors need to commit fraud: a Medicare-enrolled supplier, a physician order and an enrollee...
OIG to CMS: Stronger fraud efforts are needed for DMEPOS
August 20, 2026HME News Staff
WASHINGTON – A new Office of Inspector General (OIG) white paper warns that durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) fraud continues to cost Medicare and taxpayers millions of dollars annually despite increased oversight efforts.
The paper, “The Nation’s Challenge to Combat Durable Medical Equipment Fraud in Medicare,” focuses on three elements that bad actors need to commit fraud: a Medicare-enrolled supplier, a physician order and an enrollee...
OIG: Medicare payments for CPAP ‘generally’ comply with billing rules
April 28, 2026HME News Staff
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...
In brief: OIG’s PAP investigation, Oz’s Medicaid revalidation initiative, CCS’s agentic AI platform
April 27, 2026HME News Staff
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...
In brief: Norco Medical broadens reach, Drive Medical rebrands, OIG drops fraud video
December 1, 2025HME News Staff
BOISE, Idaho – Norco Medical has acquired Kaysville, Utah-based Petersen Medical, broadening its service offerings and reach across eight states in the Northwest.
Norco Medical expects the acquisition to drive operational excellence and elevate patient experiences.
“We are thrilled to welcome Petersen Medical to the Norco family,” said Norco Inc. President Brent Seward and CEO Nicole Kissler. “Our combined...
OIG warns of DME fraud in new video
December 1, 2025HME News Staff
WASHINGTON – The Office of Inspector General (OIG) has released a new video on combating durable medical equipment (DME) fraud. The OIG states:
“Durable medical equipment (DME), like wheelchairs, oxygen tanks and glucose monitors, is essential for millions of Americans. But this vital support system is also a frequent target for fraud, costing taxpayers billions and putting patients at risk. OIG is working to stop DME fraud through investigations, audits, evaluations and...
OIG: Medicare overpaid for CGMs
November 26, 2025HME News Staff
WASHINGTON – Medicare payments for continuous glucose monitors (CGMs) and supplies exceeded supplier acquisition costs by $377 million (or 69%) and their total estimated costs by $70 million (or 8%) in one year, according to a new report from the Office of Inspector General (OIG).
Medicare Part B payments for CGMs and supplies rose from $109 million in 2018 to $1.3 billion in 2023. Of note, CMS expanded CGM coverage to beneficiaries with Type 2 diabetes in 2023
The OIG compared...