OIG White Paper Calls for 'Bold Action' to Combat DMEPOS Fraud in Medicare
OIG White Paper Calls for 'Bold Action' to Combat DMEPOS Fraud in Medicare
On Monday, Aug. 17, the HHS Office of Inspector General (OIG) released a white paper, "The Nation's Challenge to Combat Durable Medical Equipment Fraud in Medicare" (OEI-02-24-00311), addressing fraud, waste and abuse in Medicare DMEPOS billing.
The white paper says bold action is needed to address the underlying problems allowing DMEPOS fraud to persist, and it outlines steps CMS and other stakeholders can take to stop bad actors. OIG outlines three elements bad actors need to commit fraud: a Medicare-enrolled supplier, a physician order, and an enrollee identification number.
OIG recommends CMS:
- Strengthen Medicare enrollment safeguards, including improved detection of unreported ownership changes and straw owners.
- Catch fake physician orders and fraudulent claims by engaging ordering physicians and using new technologies and analytic tools.
- Stop the use of stolen enrollee identification numbers, including partnering with social media companies to curb the sale of enrollee data and reassessing how Medicare protects enrollee ID numbers.
AAHomecare was interviewed for this report and continues to work with CMS and HHS to curb fraud, waste, and abuse in DMEPOS.