OIG: Medicare Billing for Diabetes Test Strips "Inappropriate and Questionable"

Medicare inappropriately filled $6 million in claims for diabetes testing strips in 2011, according to a report from HHS' Office of the Inspector General.

The OIG analyzed DTS claims made in 2010 and 2011 (before and after the implementation of the Competitive Bidding Program in 2011) from both suppliers and hospitals and skilled nursing facilities.

The $6 million of inappropriate claims in 2011 came on behalf of beneficiaries without a properly coded diabetes diagnosis, or that wrongly overlapped with an inpatient stay at either a hospital or skilled nursing facility. Additionally, $425 million in claims, filed by 10 percent of DTS suppliers, were questionable. Results also showed the Competitive Bidding Program reduced improper billing for mail-order supplies, but not for non-mail-order DTS.

The OIG has recommended CMS enforce existing billing system regulations, and increase monitoring of supplier Medicare billing.

More Articles on the Office of the Inspector General:

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