Industry Notes:
OIG Scrutinizes Consolidated Billing
Published on Wed Apr 06, 2011
Don't be surprised if you start getting old bills from durable medical equipment suppliers who overlapped home care episodes when furnishing nonroutine supplies (NRS). DME MACs failed to recover $3.4 million from suppliers for NRS Medicare paid for when the patient was under a home health plan of care that should have covered the supplies, says the HHS Office of Inspector General in a new report. The OIG examined claims from 2007 and 2008. "The Common Working File postpayment edit consistently identified nonroutine supplies subject to home health consolidated billing," the OIG says. "However, two of the DME MACs did not implement procedures to process and recover overpayments in a timely manner." When suppliers finally get the recoupment notices, they may come knocking on your door for payment, experts predict. The OIG also urges CMS to "implement procedures to ensure prompt and aggressive action to process and recover overpayments for [...]