CMS Targets Fraud Among DME Suppliers In Florida, Los Angeles
This article was originally published in The Gray Sheet
Executive Summary
All durable medical equipment suppliers in three counties in South Florida and four in the Los Angeles area will have to reapply for CMS-855S numbers that allow them to bill Medicare for beneficiaries' DME, prosthetics, orthotics and other medical supplies. The effort is part of a demonstration project launched by CMS July 2
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The Centers for Medicare and Medicaid Services plans to expand reviews of certain durable medical equipment claims in fiscal 2009, based on recommendations from the HHS Office of the Inspector General
Trial Run Of Expanded Medicare DME Claims Review Planned For FY 2009
The Centers for Medicare and Medicaid Services plans to expand reviews of certain durable medical equipment claims in fiscal 2009, based on recommendations from the HHS Office of the Inspector General
OIG on medical supplier fraud
An HHS Office of Inspector General 1report released March 3 finds persisting problems in Medicare compliance among suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), including hospital beds, wheelchairs and artificial limbs. OIG inspected 905 suppliers in Los Angeles County, one of the "hotspots" of supplier problems, and found in addition to other violations that 13% of suppliers did not have a physical facility or were closed during repeated visits. OIG recommends that CMS conduct more unannounced site visits, increase prepayment reviews of DMEPOS claims, and establish minimum inventory requirements for product types. CMS says it has already addressed a number of the identified fraud vulnerabilities (2"The Gray Sheet" July 9, 2007, p. 14)