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Power Mobility Coalition Voices Concern Over Government Reports Outlining Lack of Oversight in the Medicare Durable Medical Equipment Benefit
Date:9/2/2008

ht what we have been concerned about for years."

The OIG report comes on the heels of a report from the Government Accountability Office (GAO) that also highlights deficiencies in the Medicare program's fraud prevention efforts. According to the GAO report entitled, Medicare: Covert Testing Exposes Weaknesses in the Durable Medical Equipment Supplier Screening Process (GAO-08-955), investigators set up two fictitious DMEPOS companies using undercover names and bank accounts. CMS approved the companies for Medicare billing privileges despite having no clients and no inventory, exposing vulnerabilities in the DME enrollment and inspection process.

The PMC has long supported efforts to prevent fraudulent companies from being approved for the Medicare program, including a mandatory accreditation requirement and more rigorous standards that were included as part of the Medicare Modernization Act of 2003. Accreditation by a nationally recognized accreditation body will provide additional accountability, ensure program integrity and safeguard taxpayer resources.

Unfortunately, when Congress directed CMS to delay the competitive bidding program for medical equipment, CMS also cancelled the accreditation deadlines for suppliers, which will slow the accreditation process. While CMS still maintains a mandatory accreditation deadline of September 30, 2009 for all suppliers, they have ended the phase-in that accompanied competitive bidding, and would have resulted in more suppliers being accredited.

"Congress should make it clear to CMS that the delaying of competitive bidding was not meant to delay any mandatory accreditation requirements that can be useful in the fight against fraud," says Eric Sokol, PMC Director. "PMC strongly urges that a new phase-in schedule should be developed and implemented immediately. It is our hope that we can work with CMS during this critical time and establish meaningful barriers to keep fraudulent companies out of the
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SOURCE The Power Mobility Coalition
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