The Centers for Medicare & Medicaid Services (CMS) released a report stating that the 2012 improper payment rate for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) under the Medicare fee-for-service (FFS) program was $6.4 billion, or 66 percent of the total claims amount of $9.7 billion. The improper payment rate of all Medicare FFS expenditures was 8.5 percent.
DMEPOS represents approximately 2.8 percent of FFS expenditures, yet accounted for 19.8 percent of the overall improper payment rate, the report states. Most of the DMEPOS improper payments were due to insufficient documentation (94.2 percent). Just over 4 percent of the improper payments were classified as errors in medical necessity.
The highest incidence of improper payments fell outside of O&P with oxygen supplies and equipment, glucose monitors, and nebulizers and related drugs accounting for 45.8 percent of the improper payments, according to the report.