Durable medical equipment providers attract OIG’s fraud spotlight

The Center for Medicare & Medicaid Services’ next big target during its crackdown on billing fraud might be the wheelchair rather than the medical care.

Durable medical equipment (DME) providers seem to be garnishing more attention from federal agencies—Almost half of those listed on the Office of Inspector General’s Most Wanted Fugitives list are linked to fraud cases involving DME billing through either Medicare or Medicaid.

Questionable claims involving DME have been on the rise since 2009. DME billing fraud could account for $1.5 billion to $5 billion in wrongful payments a year, according to the National Insurance Crime Bureau.

Earlier this month, a Maryland DME provider was convicted of submitting nearly $600,000 in false claims for powered wheelchairs, the U.S. Attorney’s Office for the District of Columbia announced.

That same week, the owners of two Texas-based DME companies were indicted on six counts Medicare fraud involving orthopedic and prosthetic equipment and are currently await sentencing, according to the U.S. Department of Justice.

Topics: Accountable Care Organizations (ACOs) , Executive Leadership , Facility management , Medicare/Medicaid , Regulatory Compliance