Medicare Compliance & Reimbursement

Irked by telemarketing calls?

So is the HHS Office of Inspector General — and if durable medical equipment suppliers don’t take heed, they could end up defending themselves against False Claims Act charges.

In a Special Fraud Alert released March 3 — the first such issuance from the OIG since early 2000 — the watchdog agency warns DME suppliers that they can’t get around a ban on making unsolicited telephone sales calls to Medicare beneficiaries by hiring independent marketing firms.

The agency says it has received “credible information”  that some suppliers are using such firms to improperly market DME — and states in no uncertain terms such sales tactics could make them vulnerable to lawsuits under the powerful False Claims Act.

“Suppliers cannot do indirectly that which they are prohibited from doing directly,” the fraud alert states.

There are only three exceptions to the general ban on phone solicitations, the OIG points out:

• when the bene has given the supplier written permission to make contact by telephone;

• when the phone contact involves a covered item the supplier has already provided to the beneficiary; and

• when the supplier has furnished at least one covered item to the beneficiary during the preceding 15 months.

The general telemarketing ban “helps ensure Medicare beneficiaries aren’t pressured into buying items they neither need nor want and that taxpayers are not stuck paying the tab for unnecessary items,” says OIG chief Janet Rehnquist. “We are determined to investigate reports we receive about such practices and hold violators accountable,” she warns.

Lesson Learned: Suppliers considering the use of telemarketing to drum up new Medicare business should put their plans aside — or tread very carefully in accordance with the exceptions to the general telemarketing prohibition.