Year in Review: OIG's 2007 DME enforcement
Device Regulation Alert: Safety, Compliance and Reimbursement News, February 4, 2008
The Office of Inspector General (OIG) administrative and criminal enforcement actions during 2007 included several enforcement actions involving ordering and provision of durable medical equipment (DME).
These enforcement actions address activities that violate the federal False Claims Act and anti-kickback law, which prohibit improper incentives for ordering or providing DME, provision of unnecessary DME, and improper claims filing.
More than 10 enforcement actions the OIG highlights in its 2007 enforcement action summaries involve DME-related claims. DME items involved in these claims included hearing aids, aerosol medications, motorized wheelchairs, prosthetic limbs, and oxygen supplies. The most frequent cause of DME-related criminal enforcement actions was the fraudulent billing of DME that was never ordered or provided to Medicare beneficiaries. DME companies were also pursued for false claims concerning DME items, particularly for billing for unnecessary DME items.
Other DME suppliers got in trouble for kickback schemes involving orders for DME and fraudulent certificates of medical necessity.
Click here to find information about recent administrative and criminal enforcement actions on the OIG's Website.
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