Medicare improperly paid $22.7 million to suppliers from 2018 to 2024 for durable medical equipment, prosthetics, orthotics and supplies provided to enrollees during inpatient stays, according to a federal audit.
An Oct. 24 audit by HHS’ Office of Inspector General found none of the reviewed payments met Medicare rules, which prohibit suppliers from billing separately for items provided during inpatient stays. Such items must instead be provided directly by the facility or through formal arrangements with it.
Suppliers may have also collected up to $5.9 million in deductible and coinsurance payments from enrollees or their representatives, the release said.
CMS updated its system edits in January 2020, but $4.5 million in improper payments occurred after the update — about 20% of the total identified.
The OIG recommended CMS recover the overpayments and encourage refunds to affected enrollees. It also advised reviewing the edits for further refinements, though CMS did not concur with that recommendation, according to the release.
