Overpayments for DME for Patients on Hospice

WASHINGTON, D.C. (December 17, 2021)—On November 16, Department of Health and Human Services Office of Inspector General (OIG) published the report titled, “Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries.” 

The OIG found that between January 2015 and April 2019, Medicare overpaid durable medical equipment (DME) suppliers $116.9 million for DME items provided to beneficiaries enrolled in hospice. The OIG identified that the improper payments oversight process and DME supplier’s unawareness were some of the reasons for the overpayments. 

The OIG recommended the Centers for Medicare & Medicaid Services implement changes to the Common Working File (CWF) edit process, conduct data analysis to include suppliers that regularly improperly submit claims for hospice patients to target, probe and educate, and review the feasibility of expanding the hospice benefit to include coverage of all DME items patients use when enrolled in the hospice benefit program.
 
You can find AAHomecare’s summary of the report here.