CMS Approves Medicare Billing for Fictitious Suppliers

The AP/San Francisco Chronicle reports that according to a GAO report obtained by the Associated Press, in the past one year CMS has sanctioned Medicare billing rights for two fictitious medical equipment suppliers that the GAO had established in order to test the system. The two fictitious suppliers were in Maryland and Virginia. They had provided CMS with incomplete and false information regarding their legitimacy and had no clients or inventory.

The report said that had there been real fraudsters in charge of the companies, the government would have ended up shelling out millions of dollars for nonexistent supplies that these companies would have billed them for. Something really needs to be done by the CMS in order to deal with this problem. Only solution is that those responsible for ensuring compliance exercise caution and diligence when conducting inspections and screenings.

Norm Coleman (Senate Homeland Security and Governmental Affairs Investigations Subcommittee ranking member) who had originally requested the report said that this sting operation has exposed the gaps in the system that fraudsters can exploit and are exploiting. While CMS officials agreed with the findings of the report, they said that new standards have been put into place that require medical equipment suppliers to get certification before they are granted billing privileges. The extent to which these steps are going to be successful remains questionable.