We have extensive experience with RAC audits and appeals, working directly with healthcare entities subject to RAC audits.
We have represented Independent Diagnostic Testing Facilities (“IDTFs”), mobile leasing entities, radiology group practices, and other imaging providers.
We provide assistance and guidance through the legal process focused on the goal of resolving your matter successfully and efficiently.
Published on:

OIG 2011 Work Plan: Medical Equipment and Supplies

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.

Contact Information