Results of Reviews at Three Suppliers of Diabetic Testing Supplies
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For calendar years 2010 and 2011, three selected suppliers submitted claims for diabetic testing supplies without the KL modifier in accordance with Medicare requirements. The three suppliers used company-owned vehicles to deliver diabetic testing supplies to Medicare beneficiaries, which during our audit periods did not meet CMS's definition of "mail-order item." This definition allowed the suppliers to bill Medicare for non-mail-order supplies when they had delivered supplies in company-owned vehicles and to receive a higher reimbursement. If CMS's definition of "mail-order item" had included supplies delivered in company-owned vehicles and required the suppliers to claim them as mail-order supplies (i.e., with the KL modifier), we determined that Medicare would have paid approximately $4.7 million for the supplies rather than $8.2 million. In addition, we determined that the three suppliers did not routinely waive beneficiaries' coinsurance for diabetic testing supplies.
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Priority recommendations summarized.
FY 2016 Work Plan
OIG projects planned for 2016.
Significant OIG activities in 6-month increments.