DME Supplier, HHA Enforcement Efforts
December 29, 2008, CMS announced that it has revoked the billing privileges of more than 1,100 medical equipment suppliers in south Florida and the Los Angeles area as part of its DMEPOS High-Risk Suppliers Demonstration. In addition, CMS has suspended payments to a number of home health agencies (HHAs) in the Miami-Dade, Florida area. To further address waste, fraud, and abuse, CMS is implementing extensive pre- and post-payment review of claims submitted by ordering/referring physicians; validating claims submitted by physicians who order a high number of certain items or services by sending follow-up letters to these physicians; verifying the relationship between physicians who order a large number of home health services and the beneficiaries for whom they ordered those services; and identifying and visiting high risk beneficiaries to ensure they are appropriately receiving the services for which Medicare is being billed.
