Medicare Compliance & Reimbursement

Suppliers of home dialysis equipment should do their best to make sure their Medicare clients' method selections have been recorded on the CMS-382 form.

According to the HHS Office of Inspector General, Medicare paid more than $9.5 million in 2000 for end-stage renal disease claims without verifying beneficiaries' method selection. 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.

In "Home Dialysis Payment Vulnerabilities" (OEI-07-01-00570), the OIG urges the Centers for Medicare & Medicaid Services to make sure payments don't get made unless the beneficiary's method selection is recorded in the common working file - counsel CMS said it would implement. In the report, the OIG also complains that Method II payments for continuous cycling peritoneal dialysis are too high.

To see the report, go to http://oig.hhs.gov/oei/reports/oei-07-01-00570.pdf.

Lesson Learned: DME suppliers may see more claims rejections for dialysis supplies if beneficiaries' payment method selections aren't recorded on the CMS-382.