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Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Components
Centers for Medicare and Medicaid Services
Report Number
A-09-22-03003
Report Type
Audit
Number of Recommendations
4
Questioned Costs
$0
Funds for Better Use
$30,051,107
External Entity
Center for Medicare and Medicaid Services

Open Recommendations

This report has 4 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
23-A-09-092.02 No $0 $0

We recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which if in effect during our audit period could have saved Medicare as much as $30,051,107 for wheelchair repairs: review accumulated costs for wheelchair repairs that exceed the federally recommended cost limit, and for those wheelchairs that the DME MACs determine will not remain serviceable for their entire 5-year RUL, enforce Federal requirements by requiring the suppliers that transferred ownership of the wheelchairs purchased on a rental basis to enrollees to furnish replacement wheelchairs to those enrollees at no cost to the enrollees or to Medicare.

23-A-09-092.03 No $0 $0

We recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which if in effect during our audit period could have saved Medicare as much as $30,051,107 for wheelchair repairs: implement system edits to identify for review claims for repairs made to wheelchairs during their 5-year RUL when the accumulated costs of repairs have exceeded a certain cost limit.

23-A-09-092.01 No $0 $30,051,107

We recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which if in effect during our audit period could have saved Medicare as much as $30,051,107 for wheelchair repairs: strengthen Medicare requirements to ensure that DME MACs review accumulated costs of repairs made to wheelchairs (including wheelchairs purchased on a lump-sum basis) during their 5-year RUL that exceed a certain cost limit and use this cost limit as a basis for determining when wheelchairs furnished by suppliers will not remain serviceable for their entire 5-year RUL.

23-A-09-092.04 No $0 $0

We recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which if in effect during our audit period could have saved Medicare as much as $30,051,107 for wheelchair repairs: take appropriate action for suppliers that consistently bill for repairs made to wheelchairs during their 5-year RUL that exceed the federally recommended cost limit or the cost limit used as the basis for determining when wheelchairs furnished by suppliers will not remain serviceable for their entire 5-year RUL (e.g., by educating suppliers on proper billing and recovering improper payments).

Department of Health & Human Services OIG

United States