Fraud & Abuse:OIG Sets Sights On DME Suppliers

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews how the HHS Office of Inspector General planned to focus on durable medical equipment suppliers in its 2009 Work Plan. It explains the broad compliance and audit issues being watched, including documentation, claims review, medical necessity, interactions with home health agencies and nursing homes, and the use of modifiers and diagnosis coding. The piece is aimed at DME suppliers, billing and compliance staff, and other stakeholders following Medicare oversight trends.

Why This Topic Matters

It helps readers understand where federal scrutiny is likely to increase for DME suppliers and why documentation and claim-support processes matter in an audit environment.

Article Sections

  1. OIG work plan focus on DME suppliers

    Introduces the federal oversight priorities affecting durable medical equipment suppliers and the general areas under review.

  2. Documentation and claims review concerns

    Discusses the importance of documentation in supporting claims and the broad compliance concerns tied to medical necessity reviews.

  3. Related provider interactions and broader industry scrutiny

    Covers additional oversight areas involving home health agencies and nursing homes, along with the wider regulatory attention on the DME industry.

What You Will Learn

  • The general compliance themes in the OIG’s planned review of DME suppliers
  • Why documentation practices are a central issue in audit preparation
  • How broader oversight can extend to related provider settings
  • What categories of claim elements are being watched more closely

Who Should Read This

  • Durable medical equipment suppliers
  • Medical billing and coding professionals
  • Compliance officers
  • Health care attorneys
  • Revenue cycle staff

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