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Report faults Medicare audits

Washington Post, August 26, 2008

The rate of improper payments in Medicare's purchases of home medical equipment is significantly higher than the government has estimated, according to a federal audit. The report by Inspector General Daniel R. Levinson at the Department of Health and Human Services found an error rate of almost 29% in a sample of claims paid in 2006 under Medicare's durable medical equipment program. The Centers for Medicare and Medicaid Services had estimated a rate of 7.5%. "We attributed these review discrepancies to the . . . contractor's reliance on clinical inference rather than additional medical records available from healthcare providers, CMS's inconsistent policies regarding proof-of-delivery documentation, physicians' lack of understanding of documentation requirements and CMS's lack of procedures for obtaining information on high risk DME [durable medical equipment] items from beneficiaries," Levinson wrote in the report.