Performance Improvement 2009. Do Providers of Durable Medical Equipment, Prosthetics, Orthotics, and Other Medical Supplies Meet Medicare Enrollment Requirements?

01/01/2009

The study determined whether suppliers complied with Medicare equipment, prosthetics, orthotics, and supplies (DMEPOS) standards. DMEPOS are covered under Medicare Part B. Suppliers must enroll in the program to submit claims for reimbursement. Suppliers of DMEPOS have to comply with 21 Medicare DMEPOS supplier standards to enroll in the Medicare program. Reviewers conducted unannounced site visits to suppliers in Los Angeles County in 2006.

Reviewers found that 13 percent of suppliers did not maintain a physical facility or were not open during unannounced site visits. Another 9 percent were open but did not meet at least one of the two additional requirements for the standards we reviewed. An additional 14 percent met the requirements for the standards, but their claims had in common an atypical characteristic. The agency is considering seeking legislative authority to impose temporary moratoriums on supplier enrollment.

Report Title: Los Angeles County Suppliers’ Compliance With Medicare Standards: Results From Unannounced Visits http://oig.hhs.gov/oei/reports/oei-09-07-00550.pdf
Agency Sponsor: OS-OIG, Office of Inspector General
Federal Contact: Erin Lemire, 202-205-9523
Performer: Staff; Office of Inspector General
PIC ID: 9007

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