Home Health & Hospice Week

Durable medical equipment suppliers who fail to heed the HHS Office of Inspector General's special fraud alert on telemarketing are likely to pay a high price, including jail time.

DME telemarketing came into the fraud enforcement spotlight when the OIG released a March 3 alert on the issue, the first such issuance from the watchdog agency since 2000.

DME suppliers can make phone solicitations to Medicare beneficiaries in only three situations without running afoul of the law, the OIG notes: 1) when the beneficiary has given the supplier written permission to call; 2) when the phone contact involves a covered item the supplier has already provided to the beneficiary; and 3) when the supplier has furnished at least one covered item to the beneficiary during the preceding 15 months.

The consequences of overlooking the rules are becoming clear: five Washington, DC-area suppliers pleaded guilty to fraud and kickback-related charges March 20 and 21, and four of them could face jail time, says U.S. Attorney Roscoe Howard.

According to Howard, the suppliers used telemarketers to drum up Medicare business for their diabetic supply companies, illegally waived copayments for the supplies they offered and automatically renewed orders for blood glucose test supplies regardless of whether they were medically necessary or requested by the patients.

When some beneficiaries tried to cancel their orders, they were rebuffed by the suppliers, who instead continued to send the supplies - and bill Medicare. That blunder had a hefty price tag - some of the patients alerted the Centers for Medicare & Medicaid Services to the company's practices when they called the agency to complain.