Performance Improvement 2008. Do Durable Medical Equipment Suppliers Comply with Medicare Supplier Standards?


Researchers conducted unannounced visits to suppliers of Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) in three South Florida counties to determine their compliance with selected Medicare supplier standards. CMS reported that payments for DMEPOS reached $10 billion in fiscal year 2005. DMEPOS are covered under Medicare Part B and include items such as hospital beds, wheelchairs, respirators, walkers, and artificial limbs. DMEPOS suppliers must enroll in the Medicare program to sell or rent medical equipment and supplies to Medicare beneficiaries and to submit claims for Medicare reimbursement.

At the time of the review, DMEPOS suppliers had to comply with 21 Medicare DMEPOS supplier standards to enroll in the Medicare program. Researchers focused on three supplier standards that could be verified quickly through direct observation and desk review. Suppliers must maintain a physical facility, be accessible (open and staffed) during business hours, have a visible sign, have hours of operation posted, and maintain a primary business telephone listed under the name of the business. Researchers conducted unannounced site visits in late 2006 to determine whether 1,581 DMEPOS suppliers in the three counties were in compliance with these 5 requirements.

Thirty-one percent of suppliers in three South Florida counties did not maintain a physical facility or were not open and staffed during unannounced site visits. Another 14 percent were open and staffed but did not meet at least one of three additional requirements for the standards researchers reviewed.

Report Title: South Florida Suppliers' Compliance With Medicare Standards: Results From Unannounced Visits,
Agency Sponsor: OIG, Office of Inspector General
Federal Contact: Tanaz Dutia, 215-861-4567
Office of Inspector General

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"PerformanceImprovement2008.pdf" (pdf, 1.29Mb)

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