The Kaiser Network reports that the American Association for Homecare presented a 13-point plan on preventing Medicare fraud and abuse related to durable medical equipment.
According to the group’s plan, suppliers of home durable medical equipment would be subject to site inspections, and contract renewal would be contingent on these inspections. Also required under the plan would be a six-month trial period, an anti-fraud office, and stronger penalties and fines for fraud and abuse.
Medicare fraud costs upwards of $60 billion every year. Medicare spends close to $10 billion yearly on durable medical equipment.
Last year, the Government Accountability Office found that the Centers for Medicare and Medicaid Services (CMS) lacked oversight of millions of dollars in Medicare funds for durable equipment supplies and allowed “sham companies” to fraudulently bill Medicare for unnecessary or nonexistent supplies, from April 2006 through March 2007. Medicare improperly paid $1 billion for durable medical equipment, prosthetics, orthotics, and supplies in part because of fraudulent companies.
Investigators tested CMS’s oversight by setting up two fictitious supply companies, which were approved for Medicare billing privileges, even though they didn’t have clients or inventory.