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Home Health & Hospice Week

Fraud & Abuse:

CERT ERROR RATE CREATES DIFFICULTIES FOR SUPPLIERS -- AGAIN

Published on Wed Apr 22, 2009

2008 error rate for DME is 70 percent, contractor maintains. Suppliers who hoped the brouhaha over Medicare's durable medical equipment payment rate errors had died down after last year's political firestorm have unpleasant news. At the request of the Senate Finance Committee, the HHS Office of Inspector General reviewed Medicare's Comprehensive Error Rate Testing rate for fiscal year 2008. The Committee's request came after the OIG last year accused the Centers for Medicare & Medicaid Services of lowballing the DME CERT rate for 2006, with considerable political commentary (see Eli's HCW, Vol. XVII, No. 31, p. 242). This time around, CMS already had hired contractor Palmetto GBA to double-check a sample of the DME claims that CERT contractor AdvanceMed reviewed. The OIG's job was to come in after Palmetto and triple-check the results, the watchdog agency says in a new report. CMS directed Palmetto to conduct the 250-claim review based [...]
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