Sleep Management, LLC: Audit of Claims for Monthly Rental of Noninvasive Home Ventilators

Why OIG Did This Audit A previous OIG review found that medical equipment suppliers could bill Medicare for a noninvasive home ventilator (NHV) as if it were being used as a ventilator, when use of a lower cost respiratory assist device or basic continuous positive airway pressure device was indicated by the patient’s medical condition.Sleep Management, LLC (Sleep Management), was among the top three suppliers of NHVs in calendar years (CYs) 2016 and 2017. Medicare paid Sleep Management $36.8 million for NHVs during our audit period. Our objective was to determine whether Medicare claims submitted by Sleep Management for the monthly rental of NHVs complied with Medicare requirements.How OIG Did This AuditWe selected a random sample of 100 claim lines for the monthly rental of NHVs submitted by Sleep Management that Medicare paid in CYs 2016 and 2017 (audit period). An independent medical review contractor reviewed supporting documentation to determine whether the claim lines complied with Medicare coverage and payment requirements.