DMEPOS Fraud Out of Control

Weakness in the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) enrollment and inspection process have allowed sham companies to fraudulently bill Medicare for unnecessary or nonexistent supplies, according to a U.S. Government Accountability Office (GAO) summary report (GAO-08-955).

CMS in the past year approved Medicare billing privileges for two fictitious medical equipment suppliers that the GAO established to test the ability of the agency to prevent fraud, Medical News Today reported (Aug. 5).

According to the report, CMS officials said they agreed with the results of the report, but added that the agency recently implemented new standards requiring medical equipment suppliers to obtain certification before they can receive billing privileges. CMS began requiring suppliers to retain documents from physicians and restrict the use of cell phones and pagers as primary business numbers for suppliers. A competitive bidding program was also established, but is delayed due to the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 (H.R. 6331).

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