The Office of Inspector General (OIG) added two new DMEPOS items to their Work Plan for October 2024. See below for details.
Medicare Payments to Suppliers for Oxygen and Oxygen Equipment
Medicare covers reasonable and necessary durable medical equipment, prosthetics, and orthotics supplies, such as oxygen and oxygen equipment (Social Security Act §§ 1861(n), (s)(6), (8), and (9) and § 1862 (a)(1)(A)). For calendar year 2023, Medicare paid more than $674 million for oxygen and oxygen equipment. CMS has consistently identified high rates of improper payment for oxygen and oxygen equipment through its Comprehensive Error Rate Testing program. Upon request, a supplier must provide documentation, including records from the treating practitioner, indicating that oxygen and oxygen equipment were reasonable and necessary for an enrollee's condition (42 CFR § 410.38(d)(3)). The OIG will review claims to determine whether Medicare paid suppliers for oxygen and oxygen equipment according to Medicare requirements.
Wheelchair Repair Services for Medicare Enrollees
Wheelchair malfunctions and subsequent repairs are disruptive to users' mobility, and media sources have raised concerns about the timeliness and quality of wheelchair repair services. Wheelchair suppliers must adhere to quality standards set by legislation and by CMS. This evaluation will examine durable medical equipment suppliers who provide wheelchair repair services and will consider the duration of repairs, suppliers' implementation of selected quality standards, and accreditors' identification of deficiencies related to wheelchair repairs. The OIG will review documentation from wheelchair suppliers and accreditation organizations and conduct interviews with CMS, accreditation organizations, and Medicare enrollees.
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