Part B Insider (Multispecialty) Coding Alert

Published on Thu Nov 15, 2012 PDF

Your diabetic patients may have more difficulty obtaining their test strips following an OIG crackdown on supplier billing for the items.

Background: "Under Round 1 of CMS's Competitive Bidding Program, implemented in January 2011, non-mail order [diabetes test strips] in Competitive Bidding Areas (CBAs) are reimbursed at a rate more than double that of mail order DTS," the HHS Office of Inspector General explains in a new report. "This price difference provides a financial incentive for suppliers to bill for non-mail order rather than mail order DTS."

"Claims in CBAs for the more expensive, non-mail order DTS increased by 33 percent from 2010 to 2011, while claims for the less expensive, mail order DTS decreased by 71 percent," the OIG reports. "Further, for 20 percent of beneficiaries in our review, suppliers improperly billed Medicare for the more expensive, non-mail order DTS in 2011, but beneficiaries reported having instead received the less expensive, mail order DTS."

The report is online at https://oig.hhs.gov/oei/reports/oei-04-11-00760.pdf.