OIG: $6 million in Inappropriate Diabetes Billing
Aug. 27—Medicare paid for $6 million in inappropriate charges for diabetes test strips in 2011, the Office of Inspector General (OIG) found. However, the problem has been reduced by the competitive billing program.
Previous audits have reported that the $1.1 billion Medicare pays annually for test strip supplies for 4.6 million beneficiaries is particularly vulnerable to waste, fraud and abuse.The inappropriate test strip payment the OIG identified for 2011 was for beneficiaries without a documented diagnosis code for diabetes or for those who overlapped with either an inpatient hospital stay or an inpatient skilled nursing facility stay.
The OIG also raised a warning that another $425 million in Medicare-allowed claims “had characteristics of questionable billing,” according to the report.The investigation found questionable billing was reduced by the Medicare Competitive Bidding Program. The reduced rates of in questionable billing found among participants in the bidding program were not found in non-participating areas or for non-mail order diabetes suppliers.
The Centers for Medicare & Medicaid Services agreed to enforce existing processes to prevent more such inappropriate claims and it agreed to increase monitoring of such suppliers.
Publication Date: Tuesday, August 27, 2013