tci Medicare Compliance & Reimbursement - 2009 Issue 16

AUDIT: RACs to Focus on DME in SNF Stays

Equipment payments for nursing home patients not in Part A stays to get tougher. Medicare is paying unnecessary millions for ineligible durable medical equipment for nursing home patients, and it intends to crack down on the problem, according to a new report. In 2006, Medicare paid nearly $42 million for DME that wasn't allowed because the beneficiaries weren't under Medicare Part A stays in a nursing home, says the HHS Office of Inspector General. Background: For Medicare to pay for the equipment, the patient must be in a Part Astay (first 100 days) or the nursing home must qualify...

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