The Office of the Inspector General has issued a report claiming that the Medicare payment error rate for durable medical equipment in 2006 was significantly higher than the 7.5% rate claimed by the Centers for Medicare & Medicaid Services.
The findings come at a time when health officials continue an aggressive push toward urging more home- and community-based care, rather than facility-based long-term care. Much of the DME misspending centers on home health services.
An OIG investigator examined a sample of durable medical equipment claims and found the error rate could have been 29%-or nearly four times as high as the CMS estimate. The study sample included Medicare payments for wheelchairs, oxygen equipment and other DME equipment. The report, “Medical Review of Claims for the Fiscal Year 2006 Comprehensive Error Rate Testing Program,” was released Monday.
OIG investigators said that the contractor who performed the initial audit of Medicare payments neither asked for enough documentation nor reviewed available documents.
Senate Finance Committee ranking member Charles Grassley (R-IA) lashed out after receiving the findings. “If people cooked the books, manipulated the methodology, or told the contractor to ignore the rules, those individuals need to take the heat,” he said.
The full OIG audit report can be found at
http://www.oig.hhs.gov/oas/reports/region1/10700508.pdf.
