Medicare Compliance & Reimbursement

Equipment payments for nursing home patients not in Part A stays to get tougher. Medicare is paying unnecessary millions for ineligible durable medical equipment for nursing home patients, and it intends to crack down on the problem, according to a new report. In 2006, Medicare paid nearly $42 million for DME that wasn't allowed because the beneficiaries weren't under Medicare Part A stays in a nursing home, says the HHS Office of Inspector General. Background: For Medicare to pay for the equipment, the patient must be in a Part Astay (first 100 days) or the nursing home must qualify as the patient's home under Part B. Most nursing homes don't qualify as a patient's home because they provide primarily skilled care, the OIG explains. To avoid future overpayments, the OIG wants the Centers for Medicare & Medicaid Services to "routinely identify non-Part A beneficiary nursing home stays," it says. CMS [...]