Reimbursement:
MORE CLAIMS REJECTIONS LIKELY FOR DIALYSIS SUPPLIES
Published on Tue May 27, 2003
Suppliers of home dialysis equipment should make sure their Medicare clients' method selections show up on the CMS-382 form. Otherwise, they could face increased denials for dialysis supplies, a recent report shows. Medicare paid more than $9.5 million in 2000 for end-stage renal disease claims without verifying beneficiaries' method selection, according to the HHS Office of Inspector General. Under the ESRD regime, beneficiaries who choose home dialysis must select either Method I (a dialysis facility provides both services and supplies) or Method II (a dialysis facility provides services, while a durable medical equipment supplier furnishes supplies). The selection is transmitted to Medicare claims processors via the CMS-382 form. The Centers for Medicare & Medicaid Services should make sure Medicare doesn't pay for claims unless the beneficiary's method selection is recorded in the common working file, the OIG urges in "Home Dialysis Payment Vulnerabili-ties" (OEI-07-01-00570). CMS plans to implement the recommendation, it says. Method II payments for continuous cycling peritoneal dialysis are too high, the OIG also complains in the report. Editor's Note: The report is at
http://oig.hhs.gov/oei/reports/oei-07-01-00570.pdf.