CMS requires bonds, revokes billing privileges for DMEPOS suppliers
Healthcare Auditing Weekly, January 6, 2009
CMS continues to step up its efforts to combat Medicare fraud by suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), according to a CMS press release.
Certain DMEPOS suppliers are required to post a $50,000 surety bond to limit Medicare’s risk from fraudulent equipment suppliers. Existing suppliers must comply with this requirement by Oct. 2, while newly enrolling suppliers must meet this requirement by May 4. Supplier who have had certain adverse legal actions imposed against them in the past may need to post higher bonds.
In addition, CMS revoked the billing privileges for more than 1,139 DMEPOS suppliers in South Florida and southern California as part of the DMEPOS High-Risk Suppliers Demonstration that began in October 2007. CME also suspended payments to home health agencies in the Miami-Dade, FL, area.
In addition to suspending payment, CMS is:
- Implementing extensive pre- and post-payment review of claims submitted by ordering/referring physicians
- Validating claims submitted by physicians who order a high number of certain items or services by sending follow-up letters to these physicians
- Verifying the relationship between physicians who order a large number of home health services and the beneficiaries for whom they ordered those services
- Identifying and visiting high risk beneficiaries to ensure they are appropriately receiving the services for which Medicare is being billed
Comments
0 comments on “CMS requires bonds, revokes billing privileges for DMEPOS suppliers ”
Related Products
-
Briefings on The Joint Commission
Briefings on The Joint Commission will help you with all of your accreditation and survey preparation needs. Every month...
-
PPS Alert for Long-Term Care
Looking for a tool to make your job easier? PPS Alert for Long-Term Care, exclusively for the RN or MDS coordinator, is your...
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Audits in Long-Term Care: A Guide to MACs, RACs, and ZPICs
This book describes the different types of Medicare audits that nursing homes face and helps you take a proactive approach...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Capturing all necessary codes for IUD insertion and removal can be challenging
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- Q&A: Acute respiratory failure diagnosis does not require intubation
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- Oxygen Cylinder Storage Requirements
- Q&A: Follow CMS' coding guidelines when using modifier -25
- Understand the spine to code back procedures correctly
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Searched