United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2008-07-03 monographic deposited born digital 28 p. GA 1.13:GAO-08-955 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-08-955 P0b002ee18038efa2 f:d08955 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-08-955 machine generated eng fdlp REPORT GAOREPORTS-GAO-08-955 GAO-08-955 Accountability Cost analysis Documentation Fraud Health care cost control Health care costs Health care fraud Health care programs Health care services Investigations into federal agencies Medical equipment Medical supplies Medical technology Medicare Program evaluation Program management Risk assessment Risk management Strategic planning Corrective action Waste, fraud, and abuse durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) Other Written Product A82715 According to the Department of Health and Human Services (HHS), schemes to defraud the Medicare program have grown more elaborate in recent years. In particular, HHS has acknowledged Centers for Medicare & Medicaid Service's (CMS) oversight of suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) is inadequate to prevent fraud and abuse. Specifically, weaknesses in the DMEPOS enrollment and inspection process have allowed sham companies to fraudulently bill Medicare for unnecessary or nonexistent supplies. From April 2006 through March 2007, CMS estimated that Medicare improperly paid $1 billion for DMEPOS supplies--in part due to fraud by suppliers. Due to the committee's concern about vulnerabilities in the enrollment process, GAO used publicly available guidance to attempt to create DMEPOS suppliers, obtain Medicare billing numbers, and complete electronic test billing. GAO also reported on closed cases provided by the HHS Inspector General (IG) to illustrate the techniques used by criminals to fraudulently bill Medicare. On June 18, 2008, we briefed CMS representatives on the results of our investigation. In response, they acknowledged that our covert tests illustrate gaps in oversight that still require improvement and stated that they would continue to work to strengthen the entire DMEPOS enrollment process. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-08-955/html/GAOREPORTS-GAO-08-955.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-08-955/pdf/GAOREPORTS-GAO-08-955.pdf GAO-08-955 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-08-955 Other Written Product GAO-08-955; Medicare: Covert Testing Exposes Weaknesses in the Durable Medical Equipment Supplier Screening Process; Accountability Cost analysis Documentation Fraud Health care cost control Health care costs Health care fraud Health care programs Health care services Investigations into federal agencies Medical equipment Medical supplies Medical technology Medicare Program evaluation Program management Risk assessment Risk management Strategic planning Corrective action Waste, fraud, and abuse durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) Public Law 108-173