The OIG plans to examine a number of areas pertaining to medical equipment and supplies, including, but not limited to, the following:
• The appropriateness of Part B claims in selected geographic areas with high-volume claims and reimbursement for durable medical equipment (DME) suppliers of power mobility devices, hospital beds and accessories, oxygen concentrators, and enteral/parenteral nutrition.
• “Compliance of suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) with Medicare requirements for frequently replaced DME supplies.” For replacement DME supplies, a beneficiary or a beneficiary’s caregiver must request refills prior to a supplier dispensing them. The OIG has found there to be an automatic dispensing of continuous positive airway pressure systems and respiratory -assist device supplies without an order for a refill.
• Claims pertaining to power wheelchairs and whether they were appropriate and medically necessary with supporting physician documentation.
• Claims submitted with modifiers to determine if the provider has the appropriate documentation on file to support the use of the modifier.
• Medicare enrollment and monitoring of DMEPOS suppliers to screen applications with inaccurate information.
For more information, please contact The Health Law Partners, P.C. at (248) 996-8510 or (212) 734-0128 or visit the HLP website.